NPI 1093989469

Bruce Blain

Practitioner Foster Care Agency Lakeland, FL

Practice location

Address: 6642 Forestwood Dr W, Lakeland, FL 33811-2414
Phone: (863) 644-1560

Registered specialties

Foster Care Agency Primary

Agencies Taxonomy 253J00000X

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Registry record

NPI: 1093989469
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Apr 2008
Record last updated: 16 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.