Provider Demographics
NPI:1386911543
Name:MOUNSEY, BRUCE EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:EDWARD
Last Name:MOUNSEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2235 S HWY 89
Mailing Address - Street 2:STE B7
Mailing Address - City:CHINO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86323-9208
Mailing Address - Country:US
Mailing Address - Phone:928-636-6300
Mailing Address - Fax:928-636-1185
Practice Address - Street 1:1578 N STATE ROUTE 89
Practice Address - Street 2:SUITE 2
Practice Address - City:CHINO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86323-7624
Practice Address - Country:US
Practice Address - Phone:928-636-6300
Practice Address - Fax:928-636-1185
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ8384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor