Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | X009093 | NY |
NPI | 1073685673 |
---|---|
Provider Name | Dr. Stephen Anthony Brune |
First Address | Pine Bush, NY 12566-0775 |
Second Address | Montgomery, NY 12549-1248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 08/07/2007 |