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General NPI Number Information
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NPI Number | 1336491620
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Entity Type | Individual
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Provider Name | ADAM J BRUCE PHD
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Gender | Male
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 3136 HORIZON RD SUITE 100
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City | ROCKWALL
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State | TX
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Zip | 75032-7807
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Country | US
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Telephone | 972-475-8914
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Fax |
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Provider Business Mailing Address
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Address Line | 305 RIVER FERN AVE #1424
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City | GARLAND
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State | TX
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Zip | 75040-2999
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Country | US
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Telephone | 409-692-7771
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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 | 1212040
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License Number State | TX
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