Provider Demographics
NPI:1659870020
Name:HOWELL, BRUCE MASON (DPT)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:MASON
Last Name:HOWELL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 BRISTOL HWY STE 301
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1403
Mailing Address - Country:US
Mailing Address - Phone:423-262-0020
Mailing Address - Fax:
Practice Address - Street 1:3915 BRISTOL HWY STE 301
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1403
Practice Address - Country:US
Practice Address - Phone:423-262-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist