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1720105968
PETER JOHN BRUCKER
SALEM, OR
NPI
1720105968
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: OR 090007635)
Enumeration Date
2007-03-23
Last Update Date
2007-07-08
Business Address
Mr. PETER JOHN BRUCKER RN
3355 DEER LAKE CT SE
SALEM, OR 97301-9374
Phone number: 503-362-6091
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Mailing Address
Mr. PETER JOHN BRUCKER RN
PO BOX 932 3355 DEER LAKE CT SE
SALEM, OR 97308-0932
Phone number: 503-362-6091
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