Individual
MR. BRUCE G BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MSPT, CMTPT
Contact information
Practice address
3100 W MARSHALL ST, RICHMOND, VA 23230-4706
(804) 342-5857
(804) 355-0408
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-9030
(757) 873-2306
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305201809
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010061512
—
VA
01
—
225579
BCBS PHYSICAL THERAPY
VA
01
—
7900156
AETNA
VA
01
—
P00177776
MEDICARE RAILROAD
VA
Enumeration date
10/17/2006
Last updated
04/12/2018
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