Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BRADLEY BRUNNER, DC, CCSP
Active Sole ProprietorDR. BRADLEY BRUNNER, DC, CCSP is a Sports Physician (Chiropractor) healthcare provider located in LENA, Illinois. NPI 1144684564 is currently active in the NPPES registry. Verify at CMS.
Sports Physician (Chiropractor) · LENA, IL
Registration Details
- NPI Number
- 1144684564
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 12, 2016 (10.15811265858 yrs)
- Last Updated
- Dec 3, 2018
- Licenses
-
093348 (IA)5079-12 (WI)038013262 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
214 ROUSCH STLENA, IL, 610488822Browse IL providers · Browse ZIP 61048
- Phone
- 8436095944
- Primary Specialty
-
Sports Physician (Chiropractor)
111NS0005X
- Additional Specialty
- Sports Physician (Chiropractor)
- Additional Specialty
- Sports Physician (Chiropractor)
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.