Individual
MR. PETER JOHN BRUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3355 DEER LAKE CT SE, SALEM, OR 97301-9374
(503) 362-6091
Mailing address
PO BOX 932, 3355 DEER LAKE CT SE, SALEM, OR 97308-0932
(503) 362-6091
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
OR
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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