Healthcare Provider Details

I. General information

NPI: 1114918430
Provider Name (Legal Business Name): BRUCE CHARLES LINDER P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 W SAGINAW HWY STE. 205
LANSING MI
48917-1131
US

IV. Provider business mailing address

7201 W SAGINAW HWY STE. 205
LANSING MI
48917-1131
US

V. Phone/Fax

Practice location:
  • Phone: 517-321-7809
  • Fax: 517-321-7860
Mailing address:
  • Phone: 517-321-7809
  • Fax: 517-321-7860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number5501002217
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: