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Organization

E BRUNS FOOT AND ANKLE SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ERIC CARL BRUNS DPM (SOLO PRATITIONER)
(262) 248-9565
Entity
Organization

Contact information

Practice address
9916 75TH ST, SUITE 201, KENOSHA, WI 53142-7583
(262) 248-9565
(262) 248-0065
Mailing address
160 E GENEVA SQ, LAKE GENEVA, WI 53147-9694
(262) 248-9565
(262) 248-0065

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
648-025
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43215500
WI
Enumeration date
12/17/2010
Last updated
12/17/2010
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