Organization Name: | BRONCOR INC |
NPI Number: | 1134285307 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRIAN J LARSON (OWNER) |
Mailing Address: | 813 N 3rd St Suite 4 Effingham |
State: | IL US |
Postal Code: | 624013181 |
Phone Number: | 2173423218 |
Fax Number: | 2173423226 |
NPI Enumeration Date: | 12/29/2006 |
NPI Last Update Date: | 01/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Specialist/Technologist, Other |
Taxonomy Specialization: | |
Taxonomy Definition: | General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |