Individual
BRUCE CARLETON JOHNS
Active
Individual
BRUCE CARLETON JOHNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT002285E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017087720002
—
PA
01
—
03066900
CAPITAL BLUE CROSS
PA
05
—
1708772/01
—
PA
01
—
764150
BLUESHIELD
PA
Enumeration date
03/30/2006
Last updated
08/25/2011
Update your record
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