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MICHAEL T BRUCE BA

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1962652248

Individual Registrant:
 MICHAEL T BRUCE BA
Gender: M
Not Sole Proprietor

Location and contact information for practice:
330 KAY LARKIN DRIVE  PALATKA, FL 32177 US
Tel: 386-329-3780  Fax: 386-329-3786

Contact information for business:
330 KAY LARKIN DRIVE  PALATKA, FL 32177 US
Tel: 386-329-3780  Fax: 386-329-3786

Registration Information:
NPI: 1962652248
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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