Provider Demographics
NPI:1649244963
Name:BRUNO, GENE C (OMD, LAC)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:C
Last Name:BRUNO
Suffix:
Gender:M
Credentials:OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 LANCASTER DR NE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1089
Mailing Address - Country:US
Mailing Address - Phone:503-371-8770
Mailing Address - Fax:
Practice Address - Street 1:1880 LANCASTER DR NE
Practice Address - Street 2:SUITE 111
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1089
Practice Address - Country:US
Practice Address - Phone:503-371-8770
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist