Individual
MR. TODD ROBERT BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1800 15TH ST, SUITE 340, GREELEY, CO 80631-4500
(970) 378-4593
(970) 378-4591
Mailing address
5331 W 1ST ST, GREELEY, CO 80634-4230
(970) 352-5369
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2051
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95650857
—
CO
Enumeration date
04/27/2006
Last updated
07/28/2008
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