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General NPI Number Information
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NPI Number | 1932766540
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Entity Type | Individual
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Provider Name | JUSTINE BRUCE DPT
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Gender | Female
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Dates
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Enumeration Date | 05/20/2019
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 2524 N SUMMIT ST
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City | ARKANSAS CITY
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State | KS
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Zip | 67005-8808
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Country | US
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Telephone | 620-218-9718
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Fax |
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Provider Business Mailing Address
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Address Line | 1335 N 4TH ST
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City | ARKANSAS CITY
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State | KS
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Zip | 67005-1631
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Country | US
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Telephone | 620-218-9718
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 14-03886
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11-07761
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License Number State | KS
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