Basic Information
| Provider Information | |||||||||
| NPI: | 1538588132 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BREURE | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4530 E RAY RD | ||||||||
| Address2: | STE 110 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850446095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807262287 | ||||||||
| FaxNumber: | 8883169272 | ||||||||
| Practice Location | |||||||||
| Address1: | 4530 E RAY RD | ||||||||
| Address2: | STE 110 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850446095 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4807591668 | ||||||||
| FaxNumber: | 4807591669 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2014 | ||||||||
| LastUpdateDate: | 01/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 8368 | AZ | Y | Chiropractic Providers | Chiropractor |
No ID Information.