Individual
BONNIE CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
810 N TUXEDO AVE, DELAND, FL 32724-2816
(386) 734-8836
Mailing address
810 N TUXEDO AVE, DELAND, FL 32724-2816
(386) 734-8836
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
6906827
FL
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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