| NPI | 1033366273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE ALLAN HARTWIG President/Physician 904-389-6226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME0039317) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2008-09-12 |