Individual
JOHN BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3927 DARRYL LN, GAINESVILLE, GA 30506-7121
(770) 855-0898
Mailing address
3927 DARRYL LN, GAINESVILLE, GA 30506-7121
(770) 855-0898
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN085316
GA
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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