Provider Demographics
NPI:1255410015
Name:MCCALL, BRUCE S (PT ATC)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:S
Last Name:MCCALL
Suffix:
Gender:M
Credentials:PT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:429 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558
Mailing Address - Country:US
Mailing Address - Phone:707-252-4208
Mailing Address - Fax:
Practice Address - Street 1:1103 TRANCAS ST
Practice Address - Street 2:NAPA VALLEY PHYSICAL THERAPY CENTER
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558
Practice Address - Country:US
Practice Address - Phone:707-224-3131
Practice Address - Fax:707-224-2356
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT6603225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT66030Medicare ID - Type Unspecified