Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | MA 28267 | FL |
NPI | 1144529116 |
---|---|
Provider Name | Bruce Ashley Baumann |
First Address | Tallahassee, FL 32309-3609 |
Second Address | Tallahassee, FL 32304-1548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2011 |
Last Update Date | 16/03/2011 |