Individual
BRUCE BOURBEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
235 MYRTLE ST, MANCHESTER, NH 03104-4314
(603) 627-3811
Mailing address
271 WELLINGTON HILL RD, MANCHESTER, NH 03104-6463
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
910
NH
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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