Nicole Imelda Bruno, CPO, MSOP
in Spokane, WA. Individual provider (NPI-1).
NPI number1194352633
StatusActive
Last updated in NPPESJul 15, 2022
Details
- NPI
- 1194352633
- Entity type
- Individual (NPI-1)
- Name
- Nicole Imelda Bruno
- Credential
- CPO, MSOP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 25, 2020
- Certification date
- Jul 15, 2022
- Last updated
- Jul 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Z00000X | – | – | Yes | |
| 224P00000X | Prosthetist | – | – |
Practice location
514 S Washington StSpokane, WA 99204-2620
Phone 509-624-3314 · Fax 509-747-0952
Mailing address
514 S Washington StSpokane, WA 99204-2620
Phone 509-624-3314 · Fax 509-747-0952
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