Provider Demographics
NPI:1023253549
Name:BRUNER, RHETT BENJAMIN (DC)
Entity type:Individual
Prefix:DR
First Name:RHETT
Middle Name:BENJAMIN
Last Name:BRUNER
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 1:11227 LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:MT. JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122
Mailing Address - Country:US
Mailing Address - Phone:615-480-2056
Mailing Address - Fax:
Practice Address - Street 1:1501 WOODLAND POINTE DR
Practice Address - Street 2:APT 1404
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-4702
Practice Address - Country:US
Practice Address - Phone:615-480-2056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor