Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CH11436 | FL |
Y | 111NS0005X | Chiropractic Sports Physician | 038009628 | IL |
NPI | 1144381948 |
---|---|
Provider Name | Dr. Bryan T Hunte |
First Address | Bonita Springs, FL 34134-7550 |
Second Address | Bonita Springs, FL 34134-7550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 24/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
K21386 | PIN (01) | IL |
V06770 | (02) | IL |