Individual
MR. MICHAEL PHILLIP BRUECKMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, NCTMB
Contact information
Practice address
1344 STONE CREEK VALLEY CIR, O FALLON, MO 63366-3391
(636) 795-1758
Mailing address
1344 STONE CREEK VALLEY CIR, O FALLON, MO 63366-3391
(636) 795-1758
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2001025527
MO
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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