Individual
SHANE MICHAEL BRUNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
20211 PATIO DR STE 205, CASTRO VALLEY, CA 94546-4338
(510) 537-3991
Mailing address
7574 STONEDALE DR, PLEASANTON, CA 94588-3700
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49357
CA
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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