MEDICARE: MR. BRUCE LE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	1122	NC

General Provider Information

NPI Number	:	1336146190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRUCE LE

Provider Business Mailing Address
First Line	:	1599 SAND HARBOR CIR
Second Line	:
City	:	OCEAN ISLE BEACH
State	:	NC
Zip	:	28469-6045
Country	:	US
Telephone Number	:	980-721-2192
Fax Number	:

Provider Business Practice Location Address
First Line	:	1599 SAND HARBOR CIR
Second Line	:
City	:	OCEAN ISLE BEACH
State	:	NC
Zip	:	28469-6045
Country	:	US
Telephone Number	:	980-721-2192
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	09/28/2021

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Directions to “ MR. BRUCE LE ” Practice Location

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