Provider Demographics
NPI:1538588132
Name:BREURE, ERIC C (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
Last Name:BREURE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 E RAY RD
Mailing Address - Street 2:STE 110
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-6095
Mailing Address - Country:US
Mailing Address - Phone:480-726-2287
Mailing Address - Fax:888-316-9272
Practice Address - Street 1:4530 E RAY RD
Practice Address - Street 2:STE 110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6095
Practice Address - Country:US
Practice Address - Phone:480-759-1668
Practice Address - Fax:480-759-1669
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor