Organization
E BRUNS FOOT AND ANKLE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC CARL BRUNS DPM (SOLO PRACTITIONER)
(262) 248-9565
Entity
Organization
Contact information
Practice address
3805B SPRING ST, SUITE 340, RACINE, WI 53405-1641
(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
12/28/2010
Last updated
12/28/2010
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