Doctor Name: | MR. BRUCE LIVINGSTON BYNUM |
NPI Number: | 1326371022 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMT |
License Number: | MA3338 |
Business Practice Address: | 1786 Ne 179th St North Miami Beach, FL - 331621517 |
Business Phone Number: | 3058048137 |
Business Fax Number: | |
Mailing Address: | 1786 Ne 179th St, NORTH MIAMI BEACH |
State: | FL |
Postal Code: | 331621517 |
Phone Number: | 3058048137 |
Fax Number: | |
NPI Enumeration Date: | 09/12/2009 |
NPI Last Update Date: | 09/12/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA3338 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |