Individual
MRS. EDITH BONGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
4300 WEST 7TH ST, 11HC/LR, LITTLE ROCK, AR 72205
(501) 257-5084
Mailing address
136 LIMOGES CT, MAUMELLE, AR 72113-6765
(501) 851-0238
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
029
AR
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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