Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1152 | NC |
NPI | 1003834912 |
---|---|
Provider Name | Bruce Buley |
First Address | Chapel Hill, NC 27514-1586 |
Second Address | Chapel Hill, NC 27514-1586 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 11/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1152 | NC STATE LICENSURE NUMBER (01) | NC |
720783R | (05) | NC |