Individual
MR. CARL FRANCIS BRUNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2007 MEADE PKWY, SUFFOLK, VA 23434-4259
(757) 539-6300
(757) 539-0704
Mailing address
771 PILOT HOUSE DRIVE, SUITE A, NEWPORT NEWS, VA 23606
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305004860
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05954
MEDICARE GROUP PTAN
VA
Enumeration date
06/05/2006
Last updated
01/02/2018
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