Individual
BRUCE JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 TRIDENT WAY, SAN DIEGO, CA 92155-5599
(513) 641-6644
Mailing address
3398 N SIERRA SPRINGS DR, TUCSON, AZ 85712-6671
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATR-001165
AZ
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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