Provider Demographics
NPI:1912097007
Name:SALZBRUNN, JULIE LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LYNN
Last Name:SALZBRUNN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 E WASHINGTON ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-4473
Mailing Address - Country:US
Mailing Address - Phone:309-750-1819
Mailing Address - Fax:309-662-0223
Practice Address - Street 1:2415 E WASHINGTON ST
Practice Address - Street 2:SUITE F
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-4473
Practice Address - Country:US
Practice Address - Phone:309-750-1819
Practice Address - Fax:309-662-0223
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor