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Justin Bruckner, LAT, ATC
NPI 1225545411 · on the registry since 2018
Practice
- Address
- 777 Pine Ave
West Islip, NY 11795 - Phone
- (631) 456-1779
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Also registered as
- 390200000X
- Licence states on file
- PA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-09-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York