Individual
MR. CARL VICTOR BRUNELLO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
600 E SMITH RD, STE A, MEDINA, OH 44256-2666
(330) 725-4500
(330) 725-4504
Mailing address
600 E SMITH RD, STE A, MEDINA, OH 44256-2666
(330) 725-4500
(330) 725-4504
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1812
GA
111N00000X
Chiropractor
Primary
899
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000131840
ANTHEM
OH
01
—
341436169001
MEDICAL MUTUAL
OH
05
—
478666
—
OH
01
—
81439
QUALCHOICE
OH
Enumeration date
08/09/2005
Last updated
07/08/2007
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