CARL BRUCKNER


Address: 109 Thrush Dr, Roswell, GA 30075-1141
Phone: 4087310592

CARL BRUCKNER (NPI# 1144617036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144617036
Entity Type Individual
Full Name CARL BRUCKNER
Credential LMT
Practice Address 109 Thrush Dr
Roswell
GA 30075-1141
Practice Telephone 4087310592
Mailing Telephone 4087310592
Enumeration Date 2015-04-19
Last Update Date 2015-04-19
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 225700000X Massage Therapist MT 010291 GA Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 109 THRUSH DR
City ROSWELL
State GA
Zip Code 30075-1141

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1114269974 Patricia E Hernandez Nurse Practitioner 10479 Alpharetta St Ste 18, Roswell, GA 30075 2013-03-20
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Taxonomy Information

Taxonomy Code 225700000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Massage Therapist

Taxonomy Definition

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679188510 Ralonda Tooles Massage Therapist 1010 Oakhaven Dr, Roswell, GA 30075-1234 2020-09-08
1891269569 Ayesha Nesbeth-aguila Massage Therapist 425 E Crossville Rd Ste E-111, Roswell, GA 30075-5817 2019-01-16
1801384417 Cristiane Lima De Paula Massage Therapist 706 Harbor Lndg, Roswell, GA 30076-3115 2018-04-30
1710360441 Currents Massage LLC Massage Therapist 760 Old Roswell Road, Suite 230, Roswell, GA 30076 2015-06-30
1114203445 Joshua N Patton Massage Therapist 706 W 2nd St, Roswell, NM 88201-3002 2011-11-01
1437430907 Bonnie Kay Wilson Massage Therapist 321 Rosemont Ct, Roswell, GA 30076-3832 2011-08-29
1932489341 Moises S. Rodriguez Jr. Massage Therapist 310 N Richardson Ave, Roswell, NM 88201-4639 2011-08-17
1568690311 Chill Out, LLC Massage Therapist 11205 Alpharetta Hwy Ste G2, Roswell, GA 30076-5647 2009-06-30
1114167095 Sharyn Jeanne Mcclung Massage Therapist 801 Bombay Ln, Roswell, GA 30076-5819 2009-03-04
1588809107 Ivey Neuromuscular LLC Massage Therapist 425 E Crossville Rd, Suite E111, Roswell, GA 30075-5817 2008-12-10
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Competitor

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City ROSWELL
Zip Code 30075

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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