Provider Demographics
NPI:1396229068
Name:SHARON BRUCE CHIROPRACTIC PC
Entity Type:Organization
Organization Name:SHARON BRUCE CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-961-8535
Mailing Address - Street 1:4425 ATLANTIC AVE STE A10
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2245
Mailing Address - Country:US
Mailing Address - Phone:562-961-7660
Mailing Address - Fax:
Practice Address - Street 1:4425 ATLANTIC AVE STE A10
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2245
Practice Address - Country:US
Practice Address - Phone:562-961-7660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty