Mark John Brungardt, NMT

NPI #1427218528 in Lafayette, Colorado

Provider Information

NPI Number: 1427218528
Entity Type: Individual
Name: Mark John Brungardt, NMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: NMT
Enumeration Date: Jun 11, 2008
Last Updated: Jun 11, 2008

Practice Location

Address: 1280 CENTAUR VILLAGE DR STE 8
City: Lafayette
State: Colorado
ZIP Code: 80026-1255
Phone: (303) 926-1575

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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