Individual
ANTHONY JOSEPH BRUZZICHESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1206 N MAIN ST, MOUNTAIN GROVE, MO 65711-1025
(417) 926-5699
Mailing address
1480 8TH ST, WEST PLAINS, MO 65775-2010
(417) 256-5669
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2021037957
MO
225200000X
Physical Therapy Assistant
Primary
PTA4657
AR
2255A2300X
Athletic Trainer
2021024436
MO
Other
Enumeration date
07/02/2021
Last updated
12/22/2023
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