Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MICHAEL PHILLIP BRUECKMANN, LMT, NCTMB
Active Sole ProprietorSpecialist · O FALLON, MO
Registration Details
- NPI Number
- 1104939552
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 17, 2006 (19.701831982498 yrs)
- Last Updated
- Jul 8, 2007
- License
-
2001025527 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1344 STONE CREEK VALLEY CIRO FALLON, MO, 633663391Browse MO providers · Browse ZIP 63366
- Phone
- 6367951758
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in O FALLON, MO
| Name | Credential | NPI |
|---|---|---|
| HEIDI BLAYLOCK | BCBA | 1851574537 |
| REBECCA A BETHEL | P.T. | 1871822536 |
| JANICE MARIE SMITH | MA, BCBA | 1649576646 |
| TARA WALLACE | LMT, MMP | 1790124378 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.