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General NPI Number Information
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NPI Number | 1588535686
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Entity Type | Organization
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Legal Business Name | BRUCE TOTAL WELLNESS LLC
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Dates
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Enumeration Date | 09/13/2025
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Last Update Date | 09/13/2025
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Provider Practice Location Address
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Address Line | 10544 S HARLEM AVE STE 208
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City | PALOS HILLS
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State | IL
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Zip | 60465-2063
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Country | US
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Telephone | 312-588-9449
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Fax | 630-381-5279
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Provider Business Mailing Address
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Address Line | PO BOX 259
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City | OAK LAWN
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State | IL
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Zip | 60454-0259
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Country | US
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Telephone | 312-588-9449
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Fax | 630-381-5279
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Authorized Official
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Title or Position | CEO/NURSE PRACTITIONER
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Name | TASHIA BRUCE
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Credential | FNP
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Telephone | 231-638-3389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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