Individual
MR. BRUCE W. BODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1824 EAST THIRD ST., WILLIAMSPORT, PA 17701-6063
(570) 601-2200
(570) 601-2202
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
52766
CA
363A00000X
Physician Assistant
Primary
MA002013L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106930
MEDICARE
PA
Enumeration date
01/05/2006
Last updated
08/30/2020
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