Provider Demographics
NPI:1134429103
Name:BRUNO, JOHN CHRISTOPHER (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:BRUNO
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 1:125 S STATE ROAD 7
Mailing Address - Street 2:SUITE 104-274
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4385
Mailing Address - Country:US
Mailing Address - Phone:954-934-4390
Mailing Address - Fax:
Practice Address - Street 1:3767 LAKE WORTH RD
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4048
Practice Address - Country:US
Practice Address - Phone:954-934-4390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10109111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor