Individual
MS. BONNIE MEVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
1203 WASHINGTON ST, LA PORTE, IN 46350-3221
(219) 326-2397
Mailing address
421 W MADISON ST, CULVER, IN 46511-1419
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
05008814A
IN
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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