Individual
DR. BRUCE MICLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
495 WESTGATE DR, BROCKTON, MA 02301-1833
(508) 583-2011
(508) 586-5382
Mailing address
495 WESTGATE DR, BROCKTON, MA 02301-1833
(508) 583-2011
(508) 586-5382
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3174
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0353574
—
MA
01
—
150703
HARVARD PILGRIM
MA
01
—
W15693
BLUE CROSS
MA
Enumeration date
09/25/2006
Last updated
03/19/2008
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