Provider Demographics
NPI:1649655986
Name:PEARCE, BRUCE EDWARDS JR (DPT)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:EDWARDS
Last Name:PEARCE
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11809 SHADY WOOD CT
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-2500
Mailing Address - Country:US
Mailing Address - Phone:434-579-1434
Mailing Address - Fax:
Practice Address - Street 1:11809 SHADY WOOD CT
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-2500
Practice Address - Country:US
Practice Address - Phone:434-579-1434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305209538225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist