Individual
MR. BRUCE G BREWER
Active
Individual
MR. BRUCE G BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MSPT, CMTPT
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
Update your record
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