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1144617036
CARL BRUCKNER
ROSWELL, GA
NPI
1144617036
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: GA MT 010291)
Enumeration Date
2015-04-19
Last Update Date
2015-04-19
Business Address
CARL BRUCKNER LMT
109 THRUSH DR
ROSWELL, GA 30075-1141
Phone number: 408-731-0592
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Mailing Address
CARL BRUCKNER LMT
109 THRUSH DR
ROSWELL, GA 30075-1141
Phone number: 408-731-0592
Copy
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