Individual
MR. BRUCE P KIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
44 HAMILTON DR, SPOTSWOOD, NJ 08884-1271
(732) 261-0234
Mailing address
44 HAMILTON DR, SPOTSWOOD, NJ 08884-1271
(732) 261-0234
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
K46751007701492
NJ
172A00000X
Driver
—
—
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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