Brunzlick, Larry R
Brunzlick, Larry R is an individual health care provider with primary practice located at 135 South Gibson Street , Medford WI 54451. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Brunzlick, Larry R can be contacted via phone (715) 748-8100.Contact Information
Primary practice address
135 South Gibson Street
Medford WI 54451
Phone: (715) 748-8100
Fax: (715) 748-7590
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 24477 | Wisconsin |
Profile Details
| NPI number | 1770646721 |
|---|---|
| LBN Legal business name | Brunzlick, Larry R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2006 |
| Last updated | May 15th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770646721 | NPPES |
| Wisconsin | MEDICAID | 30461100 |
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