Individual
LARRY R BRUNZLICK
Active
Individual
LARRY R BRUNZLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
24477
WI
207Q00000X
Family Medicine Physician
036168466
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30461100
—
WI
Enumeration date
12/19/2006
Last updated
07/22/2026
Update your record
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