Individual
MS. MAUREEN KING BONTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
57 PORTLAND ST, SOUTH BERWICK, ME 03908-1203
(207) 384-7260
Mailing address
PO BOX 1696, OGUNQUIT, ME 03907-1696
(207) 676-4401
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT1609
ME
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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