Provider Demographics
NPI:1336113786
Name:GELCH, BRUCE M (DC)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:M
Last Name:GELCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11270 PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4101
Mailing Address - Country:US
Mailing Address - Phone:954-441-7246
Mailing Address - Fax:954-441-7241
Practice Address - Street 1:11270 PINES BLVD
Practice Address - Street 2:BRUCE GELCH DC PA
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026
Practice Address - Country:US
Practice Address - Phone:954-441-7246
Practice Address - Fax:954-441-7241
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6925111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380928500Medicaid
FL55314VMedicare PIN
U59325Medicare UPIN