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Individual

DR. BRUCE ANTHONY BORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
15831 W 12 MILE RD, SOUTHFIELD, MI 48076-3011
(248) 559-6763
(248) 559-6774
Mailing address
15831 W 12 MILE RD, SOUTHFIELD, MI 48076-3011
(248) 559-6763
(248) 559-6774

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301005884
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
950F323050
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
07/13/2005
Last updated
09/17/2012
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