Provider Demographics
NPI:1003051442
Name:BRUNO, JOEL ADRIANNA (DPT)
Entity Type:Individual
Prefix:MRS
First Name:JOEL
Middle Name:ADRIANNA
Last Name:BRUNO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 STOVALL ST SE
Mailing Address - Street 2:APT 3109
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1526
Mailing Address - Country:US
Mailing Address - Phone:404-719-2515
Mailing Address - Fax:
Practice Address - Street 1:390 STOVALL ST SE
Practice Address - Street 2:APT 3109
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-1526
Practice Address - Country:US
Practice Address - Phone:404-719-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-15
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT3118225100000X
GAPT009675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist