Stanley Todd Bruce Jr.
Physical Therapy Assistant in Tifton, GA. Individual provider (NPI-1).
NPI number1114589686
StatusActive
Last updated in NPPESJul 3, 2019
Details
- NPI
- 1114589686
- Entity type
- Individual (NPI-1)
- Name
- Stanley Todd Bruce Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 3, 2019
- Last updated
- Jul 3, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | PTA002917 | GA | Yes |
Practice location
1451 Newton DrTifton, GA 31794-3752
Phone 229-392-4426
Mailing address
1451 Newton DrTifton, GA 31794-3752
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physical Therapy Assistant providers in Tifton, GA
- Jan Carver, PTANPI 1447818364
- Miranda FurgersonNPI 1932768074
- Stephanie Drew JonesNPI 1790615532
- Megan ShippNPI 1790101673
All 5 Physical Therapy Assistant providers in Tifton · All 1,003 providers in Tifton
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