Thomas Glenn Bruno, D.C.
Individual provider Active NPI Chiropractor · Ewen, MI
NPI 1285736587 · NPPES record last updated Jun 6, 2016
Key facts
- NPI
- 1285736587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2301005867 (MI)
- Practice address
- 20312 State Highway M28
Suite a
Ewen, MI 49925-9082 - Phone
- (906) 988-2080
- Fax
- (906) 988-2080
- NPI assigned
- Sep 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1977
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
20312 State Hwy M28
Ewen, MI 49925-9082
20312 State Hwy M28 a
Ewen, MI 49925-9082
Phone (906) 988-2080
9381 Loop Rd
Trout Creek, MI 49967-9393
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101105001110 | MI | Practitioner - Chiropractic | 0143415968 | Practice locations: Ewen, MI |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301005867 | MI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301005867 | MI | Yes |
Addresses
Primary practice location
20312 State Highway M28
Suite a
Ewen, MI 49925-9082
Mailing address
9381 Loop Rd
Trout Creek, MI 49967-9393
Phone (906) 988-2080
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00126212 | Other | MI | RAILROAD MEDICARE |
| 950F650030 | Other | MI | BCBSM |
Other providers in Ewen, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.