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Individual

CHUNCHIEH BRUCE SUN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC, LMT

Contact information

Practice address
2762 GATEWAY AVE, HARTFORD, WI 53027-8310
(414) 312-1777
Mailing address
2762 GATEWAY AVE, HARTFORD, WI 53027-8310
(414) 312-1777

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
198.001288
IL
171100000X
Acupuncturist
Primary
821-55
WI
225700000X
Massage Therapist
2308-146
WI

Other

Enumeration date
01/05/2017
Last updated
01/05/2017
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