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Individual

GEORGENE BRUCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
10685 SW STONY CREEK WAY, PORT SAINT LUCIE, FL 34987-2741
(772) 252-1900
Mailing address
394 SW DALTON CIR, PORT SAINT LUCIE, FL 34953-5848
(772) 204-2821

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
21496
FL

Other

Enumeration date
12/22/2021
Last updated
12/22/2021
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