Provider Demographics
NPI:1942978473
Name:BRUNO, ROSARIO ROBERT (DC, MS, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ROSARIO
Middle Name:ROBERT
Last Name:BRUNO
Suffix:
Gender:M
Credentials:DC, MS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 E DUNN ST
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-1101
Mailing Address - Country:US
Mailing Address - Phone:813-226-7230
Mailing Address - Fax:
Practice Address - Street 1:112 W BETHALTO BLVD
Practice Address - Street 2:
Practice Address - City:BETHALTO
Practice Address - State:IL
Practice Address - Zip Code:62010-1703
Practice Address - Country:US
Practice Address - Phone:618-717-0621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor