MEDICARE: BRUCE EYER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1740935253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRUCE EYER LLC

Provider Business Mailing Address
First Line	:	690 PINKERTON RD
Second Line	:
City	:	MOUNT JOY
State	:	PA
Zip	:	17552-9239
Country	:	US
Telephone Number	:	717-333-3220
Fax Number	:	717-653-0294

Provider Business Practice Location Address
First Line	:	719 OLDE HICKORY RD STE A
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-4985
Country	:	US
Telephone Number	:	717-333-3220
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	BRUCE EYER
Credential	:	MS
Telephone Number	:	717-333-3220

Provider Enumeration Date	:	02/14/2022
Last Update Date	:	02/14/2022

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