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Individual

MR. BRUCE ARTHUR WRAA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MT, ASCP

Contact information

Practice address
5255 S CATHAY WAY, CENTENNIAL, CO 80015-4859
(303) 693-2126
Mailing address
5255 S CATHAY WAY, CENTENNIAL, CO 80015-4859
(303) 693-2126

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
MTA22223
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MT-98209
AMER. SOC. OF CLIN PATH. CERTIFIED MEDICAL TECHNOLOGIST
01
MTA 22223
CALIFORNIA LICENSED MEDICAL TECHNOLOGIST
CA
Enumeration date
02/12/2009
Last updated
02/12/2009
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