Provider Demographics
NPI:1700288313
Name:MCVEY, BRUCE WILLIAM
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:WILLIAM
Last Name:MCVEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 E CHANDLER BLVD
Mailing Address - Street 2:APT. 212
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-5846
Mailing Address - Country:US
Mailing Address - Phone:602-999-9811
Mailing Address - Fax:
Practice Address - Street 1:3425 E CHANDLER BLVD
Practice Address - Street 2:APT. 212
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-5846
Practice Address - Country:US
Practice Address - Phone:602-999-9811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5132224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant