Individual
LISA BRUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 N FERN ABBEY LN, CARY, NC 27518-8981
(919) 647-4763
Mailing address
111 N FERN ABBEY LN, CARY, NC 27518-8981
(919) 647-4763
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12968
NC
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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