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General NPI Number Information
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NPI Number | 1114832664
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Entity Type | Individual
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Provider Name | TI'ANNA BRUCE DPT
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Gender | Female
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Dates
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Enumeration Date | 08/18/2026
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Last Update Date | 08/18/2026
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Provider Practice Location Address
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Address Line | 7727 W DEER VALLEY RD STE 210
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City | PEORIA
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State | AZ
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Zip | 85382-2120
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Country | US
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Telephone | 623-208-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 15431 N 67TH AVE APT 3056
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City | GLENDALE
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State | AZ
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Zip | 85306-3777
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | LPT-034924
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License Number State | AZ
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