Provider Demographics
NPI:1558179432
Name:BRUCE, MEREDITH ORR (PT)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ORR
Last Name:BRUCE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:ROSE
Other - Last Name:ORR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:260 PEACHTREE ST NW STE 2200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-1292
Mailing Address - Country:US
Mailing Address - Phone:866-839-6979
Mailing Address - Fax:
Practice Address - Street 1:260 PEACHTREE ST NW STE 2200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1292
Practice Address - Country:US
Practice Address - Phone:866-839-6979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007227225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist