Individual
CANDICE S BRUECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
321 MAIN STREET, SUITE D, WINOOSKI, VT 05404
(802) 864-3785
(802) 864-0274
Mailing address
321 MAIN STREET, SUITE D, WINOOSKI, VT 05404
(802) 864-3785
(802) 864-0274
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400003490
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06558898
BLUE CROSS
—
01
—
360645
MVP
—
01
—
5270302
VMC EMI
—
Enumeration date
11/10/2006
Last updated
07/08/2007
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