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Individual

MRS. AMANDA A BRUCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
115-A BRUSHY CREEK RD, EASLEY, SC 29642-1120
(864) 343-2650
(864) 343-2680
Mailing address
PO BOX 2225, EASLEY, SC 29641-2225
(864) 343-2650
(864) 343-2680

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5327
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9429
MEDICARE GROUP PTAN
SC
Enumeration date
09/11/2008
Last updated
04/13/2015
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