Most Relevant Information
Provider Data
| NPI Number: | 1003384926 |
| Provider Name: | MIKAEL LAURSEN BRUCKER LAC, ND |
| Entity Type: | Individual |
| Taxonomy Code: | 175F00000X |
| Specialty: | Naturopath |
| License Number: | 099.0134073 |
Most Important Dates
| Enumeration Date: | 11/08/2018 |
| Last Updated: | 11/08/2018 |
Provider Practice Location
710 MEETINGHOUSE RD
ELKINS PARK
PA
19027
Practice Location Phone/Fax
| Phone: | 2159191166 |
| Fax: |
Provider Mailing Location
710 MEETINGHOUSE RD
ELKINS PARK
PA
190271417
Provider Mailing Phone/Fax
| Phone: | 2159191166 |
| Fax: |