Individual
DEMETRI ANTONI BRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MCD, CCC-SLP
Contact information
Practice address
1699 RED WOLF BLVD, JONESBORO, AR 72401-5442
(870) 336-0021
Mailing address
212 CHICAGO ST, CARAWAY, AR 72419-9027
(870) 371-1809
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4348
AR
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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