Individual provider · NPI-1

Dr. Bruce Anthony Born, D.C.

Chiropractor · Southfield, MI

NPI number1649278490
StatusActive
Last updated in NPPESSep 17, 2012

Details

NPI
1649278490
Entity type
Individual (NPI-1)
Name
Dr. Bruce Anthony Born
Credential
D.C.
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 13, 2005
Last updated
Sep 17, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor2301005884MIYes

Practice location

15831 W 12 Mile Rd
Southfield, MI 48076-3011

Phone 248-559-6763 · Fax 248-559-6774

Mailing address

15831 W 12 Mile Rd
Southfield, MI 48076-3011

Phone 248-559-6763 · Fax 248-559-6774

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