Individual
BRUCE HAYWARD BISSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
36682 ANGELO RD, LONG BOTTOM, OH 45743-9779
(740) 236-3370
Mailing address
36682 ANGELO RD, LONG BOTTOM, OH 45743-9779
(740) 236-3370
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
IP407465
OH
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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