Individual
MR. BRUCE BOSWELL INNISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT, OCS
Contact information
Practice address
6475 ALVARADO RD, #118, SAN DIEGO, CA 92120-5003
(619) 287-4678
(619) 287-0350
Mailing address
11448 SHADOW RANCH RD, LA MESA, CA 91941-8204
(619) 670-3697
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT 9777
CA
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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