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1891800702
JODY BRENT BRUCKER
TERRE HAUTE, IN
NPI
1891800702
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN 36001007A)
Enumeration Date
2006-08-20
Last Update Date
2007-07-08
Business Address
Dr. JODY BRENT BRUCKER ATC
200 N 7TH ST C-11, ARENA BUILDING
TERRE HAUTE, IN 47809-1902
Phone number: 812-237-3962
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Mailing Address
Dr. JODY BRENT BRUCKER ATC
7599 S WILLIAMSBURG ST
TERRE HAUTE, IN 47802-9336
Phone number: 812-298-8779
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