Provider Demographics
NPI:1245503184
Name:PATRICK J. BRUNNER D LLC
Entity type:Organization
Organization Name:PATRICK J. BRUNNER D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-922-0606
Mailing Address - Street 1:5330 RAPID RUN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-4244
Mailing Address - Country:US
Mailing Address - Phone:513-922-0606
Mailing Address - Fax:513-922-5863
Practice Address - Street 1:5330 RAPID RUN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-4244
Practice Address - Country:US
Practice Address - Phone:513-922-0606
Practice Address - Fax:513-922-5863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0755111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0426975Medicaid
OH=========OtherTAX ID NUMBER
OHT47023Medicare UPIN
OHBR0459033Medicare PIN