Individual
MR. GUSTAVE POLZER BRUCKER IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
33 PEARL STREET, WESTERLY, RI 02891
(401) 742-1539
Mailing address
33 PEARL STREET, WESTERLY, RI 02891
(401) 742-1539
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007159
CT
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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