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Individual

MRS. JACQUELINE KENNEDY-BOWMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RRT

Contact information

Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(271) 554-5211
Mailing address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(271) 554-5211

Taxonomy

Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
30001321A
IN

Other

Enumeration date
06/01/2010
Last updated
06/01/2010
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