Provider Demographics
NPI:1508370826
Name:BRUNO CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:BRUNO CHIROPRACTIC INC.
Other - Org Name:BRUNO CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-353-5990
Mailing Address - Street 1:1822 MINERAL SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:N PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-8938
Mailing Address - Country:US
Mailing Address - Phone:401-353-5990
Mailing Address - Fax:
Practice Address - Street 1:1822 MINERAL SPRING AVE
Practice Address - Street 2:
Practice Address - City:N PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-8938
Practice Address - Country:US
Practice Address - Phone:401-353-5990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00639261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty