Individual
BRUCE GILLIARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-6195
Mailing address
8709 GROUSE RUN LN, FAYETTEVILLE, NC 28314-6076
(910) 551-3585
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P9404
NC
Other
Enumeration date
11/13/2010
Last updated
11/13/2010
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