Provider Demographics
NPI:1487537197
Name:BRUCE, LENNY L (PT)
Entity type:Individual
Prefix:
First Name:LENNY
Middle Name:L
Last Name:BRUCE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:LEONARD
Other - Middle Name:L
Other - Last Name:BRUCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:259 WILLOW RUN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-2717
Mailing Address - Country:US
Mailing Address - Phone:865-216-3814
Mailing Address - Fax:
Practice Address - Street 1:259 WILLOW RUN
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-2717
Practice Address - Country:US
Practice Address - Phone:865-216-3814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4898225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist