Organization
RAPHAEL BONELLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAPHAEL BONELLE (CASE MANAGER)
(405) 510-4108
Entity
Organization
Contact information
Practice address
12201 GARDEN CT, OKLAHOMA CITY, OK 73170-4006
(405) 510-4108
Mailing address
12201 GARDEN CT, OKLAHOMA CITY, OK 73170-4006
(405) 510-4108
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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