Individual
BRUCE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3564 MAURICIA AVE, SANTA CLARA, CA 95051-6618
(408) 338-9277
Mailing address
3564 MAURICIA AVE, SANTA CLARA, CA 95051-6618
(408) 338-9277
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
90195
CA
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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