Provider Demographics
NPI:1790069433
Name:BRUNI, GARRETT THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:THOMAS
Last Name:BRUNI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 E. HIGGINS RD.
Mailing Address - Street 2:
Mailing Address - City:GILBERTS
Mailing Address - State:IL
Mailing Address - Zip Code:60136-9627
Mailing Address - Country:US
Mailing Address - Phone:847-551-5550
Mailing Address - Fax:847-551-9560
Practice Address - Street 1:219 E. HIGGINS RD.
Practice Address - Street 2:
Practice Address - City:GILBERTS
Practice Address - State:IL
Practice Address - Zip Code:60136-9627
Practice Address - Country:US
Practice Address - Phone:847-551-5550
Practice Address - Fax:847-551-9560
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2013-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012033111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor