Individual
MS. BONNIE PROVENZANO CHRYSLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 SUNNYVIEW LN, KALISPELL, MT 59901-3120
(406) 751-4189
(406) 751-4527
Mailing address
20480 MT HIGHWAY 35, BIGFORK, MT 59911-8225
(406) 982-3470
(406) 751-4145
Taxonomy
Speciality
Code
Description
License number
State
163WX0106X
Occupational Health Registered Nurse
Primary
RN6215
MT
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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