Provider Demographics
NPI:1821327859
Name:BRAUN CHIROPRACTIC LTD
Entity Type:Organization
Organization Name:BRAUN CHIROPRACTIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:520-281-1300
Mailing Address - Street 1:1821 N MASTICK WAY
Mailing Address - Street 2:STE #1
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-1031
Mailing Address - Country:US
Mailing Address - Phone:520-281-1300
Mailing Address - Fax:520-281-4185
Practice Address - Street 1:1821 N MASTICK WAY
Practice Address - Street 2:STE #1
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-1031
Practice Address - Country:US
Practice Address - Phone:520-281-1300
Practice Address - Fax:520-281-4185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDC5083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZDC5083Medicare PIN