Provider Demographics
NPI:1134891179
Name:DOCTOR TO YOU
Entity type:Organization
Organization Name:DOCTOR TO YOU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:760-484-6469
Mailing Address - Street 1:1400 BRITTANY LN NE APT A106
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5779
Mailing Address - Country:US
Mailing Address - Phone:760-484-6469
Mailing Address - Fax:
Practice Address - Street 1:1400 BRITTANY LN NE APT A106
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-5779
Practice Address - Country:US
Practice Address - Phone:760-484-6469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center