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Individual

MRS. BONNIE SUMMERS OVITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
9 STEVENS LN, FORT EDWARD, NY 12828-1211
(518) 747-8985
Mailing address
9 STEVENS LN, FORT EDWARD, NY 12828-1211
(518) 747-8985

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
196736-1
NY

Other

Enumeration date
11/30/2009
Last updated
11/30/2009
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