Provider Demographics
NPI:1770642753
Name:BRONSON, LYNNE (DC)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:BRONSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 W 10TH ST STE B8A
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-1599
Mailing Address - Country:US
Mailing Address - Phone:970-346-1814
Mailing Address - Fax:970-346-1820
Practice Address - Street 1:3820 W 10TH ST STE B8A
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-1599
Practice Address - Country:US
Practice Address - Phone:970-346-1814
Practice Address - Fax:970-346-1820
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5474111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor