Provider Demographics
NPI:1487255840
Name:HARRISBURG JOINT AND MUSCLE, LLC
Entity type:Organization
Organization Name:HARRISBURG JOINT AND MUSCLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRUNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-999-4347
Mailing Address - Street 1:1 LEMOYNE SQ STE 100
Mailing Address - Street 2:
Mailing Address - City:LEMOYNE
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1230
Mailing Address - Country:US
Mailing Address - Phone:717-999-4347
Mailing Address - Fax:
Practice Address - Street 1:1 LEMOYNE SQ STE 100
Practice Address - Street 2:
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043-1230
Practice Address - Country:US
Practice Address - Phone:717-999-4347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty