Individual
MR. JEROME MARK BRUNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
216 8TH ST, LAFAYETTE, LA 70501-7163
(985) 397-0290
(225) 931-9664
Mailing address
529 POTIER RD LOT B, CARENCRO, LA 70520-6237
(337) 520-1813
(225) 831-9664
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
1171824
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1171824
—
LA
Enumeration date
03/18/2022
Last updated
03/22/2022
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