Individual
MRS. MALETA ANDREA BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
1200 E MOREHEAD ST STE 20Q, CHARLOTTE, NC 28204-2872
(704) 712-0413
Mailing address
8807 KIRCHENBAUM DR, CHARLOTTE, NC 28210-7657
(704) 712-0413
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
13583
SC
225700000X
Massage Therapist
Primary
21419
NC
Other
Enumeration date
07/27/2024
Last updated
07/27/2024
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