Individual
BRIAN BRUNSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 W MAIN ST, FLEETWOOD, PA 19522-1323
(610) 644-0445
Mailing address
1 W MAIN ST, FLEETWOOD, PA 19522-1323
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BH001756
PA
Other
Enumeration date
06/09/2014
Last updated
06/09/2014
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