Provider Demographics
NPI:1356510416
Name:C L BRUNETTO D C INC
Entity Type:Organization
Organization Name:C L BRUNETTO D C INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRUNETTO
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:719-544-5552
Mailing Address - Street 1:540 E ABRIENDO AVE STE F
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-2388
Mailing Address - Country:US
Mailing Address - Phone:719-544-5552
Mailing Address - Fax:
Practice Address - Street 1:540 E ABRIENDO AVE STE F
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-2388
Practice Address - Country:US
Practice Address - Phone:719-544-5552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2865111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty