Provider Demographics
NPI:1174691026
Name:BRAUN CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:BRAUN CHIROPRACTIC CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-364-1883
Mailing Address - Street 1:3132 N GRIMES ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240
Mailing Address - Country:US
Mailing Address - Phone:505-392-3561
Mailing Address - Fax:505-392-4771
Practice Address - Street 1:248 SONORA DR
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-6343
Practice Address - Country:US
Practice Address - Phone:910-364-1883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1421332B00000X, 335E00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
U67723Medicare UPIN