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Individual

BRUCE A HUDDLESTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
4608 W NIXON ST, PASCO, WA 99301-2834
(239) 770-7612
Mailing address
4608 W NIXON ST, PASCO, WA 99301-2834
(239) 770-7612

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
00003987
WA
225XP0200X
Pediatric Occupational Therapist
8373
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891065100
FL
Enumeration date
10/15/2006
Last updated
01/16/2011
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