Individual
MS. BONNIE ANN OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
27100 CHARDON RD, RICHMOND HEIGHTS, OH 44143-1116
(440) 585-6500
(330) 345-2473
Mailing address
2688 E SMITHVILLE WESTERN RD, WOOSTER, OH 44691-1051
(330) 466-1262
(330) 345-2473
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.002088
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA251-91
MEDICARE
OH
Enumeration date
01/18/2008
Last updated
01/18/2008
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