Individual
CLINTON BRUNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2535 IRA E WOODS AVE, GRAPEVINE, TX 76051
(817) 481-2121
Mailing address
2535 IRA E WOODS AVE, GRAPEVINE, TX 76051-3930
(817) 481-2121
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1292490
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192079501
—
TX
Enumeration date
07/26/2017
Last updated
10/01/2019
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