IndividualActive
Bradley Brunner, DC, CCSP
NPI 1144684564 · Sports Physician Chiropractor · Lena, IL
Provider details
- NPI number
- 1144684564
- Entity type
- Individual
- Primary specialty
- Sports Physician ChiropractorChiropractic Providers
- Credential
- DC, CCSP
- Sex
- Male
- Sole proprietor
- Yes
- License
- 093348 (IA)
Specialties & taxonomies
Chiropractic Providers
Chiropractic Providers
Chiropractic Providers
Practice location
214 Rousch St
Lena, IL 61048-8822
Phone: (843) 609-5944
Approximate (ZIP-level) locationGet directions
Mailing address
214 Rousch St
Lena, IL 61048-8822
Registry dates
- Enumerated
- 2016-04-12
- Last updated
- 2018-12-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.