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
Fax: (715) 748-7590
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1770646721 NPPES
Wisconsin MEDICAID 30461100

Popular Providers