Organization
BRUCE WILLNER DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE WILLNER DO (OWNER/PRESIDENT)
(330) 759-8050
Entity
Organization
Contact information
Practice address
3622 BELMONT AVE STE 18, YOUNGSTOWN, OH 44505-1444
(330) 759-8050
(330) 759-1246
Mailing address
3622 BELMONT AVE STE 18, YOUNGSTOWN, OH 44505-1444
(330) 759-8050
(330) 759-1246
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0791899
—
OH
01
—
34-004681
LIC #
OH
Enumeration date
09/27/2018
Last updated
09/27/2018
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