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General NPI Number Information
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NPI Number | 1972841096
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Entity Type | Individual
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Provider Name | JOSHUA BRUINSMA
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Gender | Male
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 2916 YATES RD
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City | HILLSBOROUGH
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State | NC
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Zip | 27278
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Country | US
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Telephone | 860-559-8035
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Fax |
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Provider Business Mailing Address
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Address Line | 49 VENICE DR
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City | BURLINGTON
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State | CT
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Zip | 06013-2509
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2138
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A4991
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License Number State | NC
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