Individual
MR. BRUCE E. O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
102 HINES ROAD, CALHOUN, GA 30701
(770) 928-0763
Mailing address
611 LOVINGGOOD TRL, WOODSTOCK, GA 30189-7413
(770) 928-0763
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
000011
GA
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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