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Individual

SPENCER REECE BRAUCHLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
6265 E 400 S, LAOTTO, IN 46763-9772
(260) 318-5285
Mailing address
6265 E 400 S, LAOTTO, IN 46763-9772
(260) 318-5285

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08003146A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08003146A
INDIANA STATE CHIROPRACTIC LICENSE NUMBER
IN
Enumeration date
02/01/2020
Last updated
02/01/2020
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