Individual
JODY LEE BONTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
72 FRONT ST, SUITE 16, BATH, ME 04530-2657
(207) 522-4092
Mailing address
72 FRONT ST, SUITE 16, BATH, ME 04530-2657
(207) 522-4092
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT2101
ME
Other
Enumeration date
12/18/2008
Last updated
12/18/2008
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