Bruce Theall Dpm Llc

NPI 1043518913 - Durable Medical Equipment & Medical Supplies - 332B00000X

NPI Details
NPI 1043518913
Enumeration Date 03/02/2011
Last Updated 12/10/2013
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name BRUCE P BRUCE
Position OWNER/MEDICAL DIRECTOR
Phone (973) 673-3668
Fax (862) 252-9542
Practice Location
310 CENTRAL AVENUE
SUITE 301
EAST ORANGE NJ, 07018-2835, US
Phone (973) 673-3668
Fax (862) 252-9542
Business Location
310 CENTRAL AVENUE
SUITE 301
EAST ORANGE NJ, 07018-2835, US
Phone (973) 673-3668
Fax (862) 252-9542
Toxanomy
Taxonomy Code 332B00000X
License State
License Number
Remove 1043518913 NPI Number
 

According to our database, Bruce Theall Dpm Llc NPI is 1043518913, taxonomy code is 332B00000X Bruce Theall Dpm Llc physically located at 310 Central Avenue, East Orange NJ, 07018-2835. NPI Number 1033115704 has the healthcare provider type.

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1043518913 NPI number is provided on an as is basis without warranty of any kind. 1043518913 is maintained by the National Plan & Provider Enumeration System. The contents of Bruce Theall Dpm Llc are for informational purposes only.