Individual
DR. JODY BRENT BRUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
200 N 7TH ST, C-11, ARENA BUILDING, TERRE HAUTE, IN 47809-1902
(812) 237-3962
Mailing address
7599 S WILLIAMSBURG ST, TERRE HAUTE, IN 47802-9336
(812) 298-8779
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001007A
IN
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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