Individual
DR. BRADLEY BRUNNER
Active
Individual
DR. BRADLEY BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, CCSP
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
038013262
IL
111NS0005X
Sports Physician Chiropractor
093348
IA
111NS0005X
Sports Physician Chiropractor
5079-12
WI
Other
Enumeration date
04/12/2016
Last updated
12/03/2018
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