Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. BRUCE J. WALLENTINE, MPT

Active Sole Proprietor

MR. BRUCE J. WALLENTINE, MPT is a Physical Therapy Assistant healthcare provider located in OVID, Idaho. NPI 1023129251 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · OVID, ID

Registration Details

NPI Number: 1023129251
Provider Type: Individual
Gender: Male
NPI Issued: Aug 31, 2006 (19.936881609951 yrs)
Last Updated: Jul 8, 2007
Licenses: PT-593 (ID)

PT-389 (WY)

362968-2401 (UT)
Sole Proprietor: Yes

Practice Information

Address: 900 LANARK RD

OVID, ID, 832544934
Browse ID providers · Browse ZIP 83254
Phone: 2089452900
Fax: 2089452900
Primary Specialty: Physical Therapy Assistant
225100000X
Additional Specialty: Physical Therapy Assistant
Additional Specialty: Physical Therapy Assistant

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.