Individual
MR. CODY BRUNCLIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2461 84TH AVE, OSCEOLA, WI 54020-4338
(715) 417-2618
Mailing address
2461 84TH AVE, OSCEOLA, WI 54020-4338
(715) 417-2618
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/27/2015
Last updated
03/27/2015
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