Reuben Bontrager

NPI #1538351184 in Marianna, Florida

Provider Information

NPI Number: 1538351184
Entity Type: Organization
Organization Name: Reuben Bontrager
Primary Specialty: General Practice
Enumeration Date: Aug 16, 2007
Last Updated: Feb 25, 2008

Practice Location

Address: 4439 JACKSON ST STE B
City: Marianna
State: Florida
ZIP Code: 32448-4660
Phone: (850) 482-2264

Authorized Official

Name: MRS. CAROL SUTTON, MD.
Title: MEDICAL DIRECTOR
Phone: (850) 482-2264

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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