# BRONCOR INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134285307
- **Authorized official:** BRIAN J LARSON (OWNER)
- **Authorized official phone:** (217) 342-3218

## Contact information

- **Practice address:** 813 N 3RD ST, SUITE 4, EFFINGHAM, IL 62401-3181
- **Practice address phone:** (217) 342-3218
- **Practice address fax:** (217) 342-3226
- **Mailing address:** PO BOX 1527, EFFINGHAM, IL 62401-1527
- **Mailing address phone:** (217) 342-3218
- **Mailing address fax:** (217) 342-3226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 246Z00000X | Other Specialist/Technologist | — | NULL | Yes |
| 246Z00000X | Other Specialist/Technologist | — | — | Yes |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 01/19/2012