Individual
MR. BRUCE G MANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-7010
(207) 662-8133
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-7010
(207) 662-8133
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-599
ME
Other
Enumeration date
10/04/2006
Last updated
05/11/2012
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