Provider Demographics
NPI:1811725799
Name:ADVANTAGE HEALTH CENTER LLC
Entity type:Organization
Organization Name:ADVANTAGE HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BRULEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-313-0935
Mailing Address - Street 1:2513 E CLAIREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6725
Mailing Address - Country:US
Mailing Address - Phone:715-313-0935
Mailing Address - Fax:
Practice Address - Street 1:2513 E CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6725
Practice Address - Country:US
Practice Address - Phone:715-313-0935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty