Provider Demographics
NPI:1295728376
Name:WEARY, BRUCE A (DC)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:A
Last Name:WEARY
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:730 N MONTEZUMA ST
Mailing Address - Street 2:STE B
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-2039
Mailing Address - Country:US
Mailing Address - Phone:928-778-2227
Mailing Address - Fax:928-771-9159
Practice Address - Street 1:730 N MONTEZUMA ST
Practice Address - Street 2:STE B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-2039
Practice Address - Country:US
Practice Address - Phone:928-778-2227
Practice Address - Fax:928-771-9159
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2016-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ3936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZT-42250Medicare UPIN
AZ118416Medicare PIN