Healthcare Provider Details

I. General information

NPI: 1134128713
Provider Name (Legal Business Name): BRUCE ALAN APPLE MS,PT,ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 BAINBRIDGE ST
PHILADELPHIA PA
19147-1568
US

IV. Provider business mailing address

1888 ROUTE 70 E
CHERRY HILL NJ
08003-2178
US

V. Phone/Fax

Practice location:
  • Phone: 215-629-1270
  • Fax: 215-629-5531
Mailing address:
  • Phone: 856-424-7524
  • Fax: 856-424-7599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberQAO03263
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number002052E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: