Individual
JACOB BONVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
251 N MAIN ST, CEDARVILLE, OH 45314-8501
(937) 766-7905
Mailing address
251 N MAIN STREET, ATHLETIC TRAINING, CEDARVILLE, OH 45314-9998
(207) 551-7281
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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