Provider Demographics
NPI:1396426284
Name:BRUCE, DONNIE WALTER JR (RRT)
Entity type:Individual
Prefix:MR
First Name:DONNIE
Middle Name:WALTER
Last Name:BRUCE
Suffix:JR
Gender:M
Credentials:RRT
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Mailing Address - Street 1:926 SAMUEL LN
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4402
Mailing Address - Country:US
Mailing Address - Phone:704-248-1000
Mailing Address - Fax:
Practice Address - Street 1:2360 E PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-5356
Practice Address - Country:US
Practice Address - Phone:307-778-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1364227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered