Provider Demographics
NPI:1366951550
Name:BRACE, CHUN CHI (ND)
Entity type:Individual
Prefix:DR
First Name:CHUN
Middle Name:CHI
Last Name:BRACE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 BONFORTE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1680
Mailing Address - Country:US
Mailing Address - Phone:719-924-9532
Mailing Address - Fax:
Practice Address - Street 1:1624 BONFORTE BLVD STE B
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1680
Practice Address - Country:US
Practice Address - Phone:719-924-9532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COND.0000111175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath