# REUBEN BONTRAGER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** B.T.Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538351184
- **Authorized official:** MRS. CAROL SUTTON MD. (MEDICAL DIRECTOR)
- **Authorized official phone:** (850) 482-2264

## Contact information

- **Practice address:** 4439 JACKSON ST STE B, MARIANNA, FL 32448-4660
- **Practice address phone:** (850) 482-2264
- **Practice address fax:** (850) 482-5270
- **Mailing address:** 4439 JACKSON ST STE B, MARIANNA, FL 32448-4660
- **Mailing address phone:** (850) 482-2264
- **Mailing address fax:** (850) 482-5270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/16/2007
- **Last updated:** 02/25/2008