Individual
JENNIFER L BONGARTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420-0160
(505) 368-6001
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
RP00007685
NM
Other
Enumeration date
12/23/2011
Last updated
08/23/2013
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