Provider Demographics
NPI:1801079272
Name:BRUNS, RICK E (DC)
Entity type:Individual
Prefix:DR
First Name:RICK
Middle Name:E
Last Name:BRUNS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1140 SE 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1110
Mailing Address - Country:US
Mailing Address - Phone:954-764-8505
Mailing Address - Fax:954-467-8723
Practice Address - Street 1:1140 SE 3RD AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1110
Practice Address - Country:US
Practice Address - Phone:954-764-8505
Practice Address - Fax:954-467-8723
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-08
Last Update Date:2007-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCHOOO2690111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic