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1417004243
BRUCE BOSWELL INNISS
SAN DIEGO, CA
NPI
1417004243
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2251X0800X Physical Therapist, Orthopedic
(Licence: CA PT 9777)
Enumeration Date
2007-01-04
Last Update Date
2007-07-08
Business Address
Mr. BRUCE BOSWELL INNISS RPT, OCS
6475 ALVARADO RD #118
SAN DIEGO, CA 92120-5003
Phone number: 619-287-4678
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Mailing Address
Mr. BRUCE BOSWELL INNISS RPT, OCS
11448 SHADOW RANCH RD
LA MESA, CA 91941-8204
Phone number: 619-670-3697
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