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General NPI Number Information
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NPI Number | 1922318310
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Entity Type | Organization
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Legal Business Name | JAMIE S BONATCH LLC
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 141 S JEFFERSON ST
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City | KITTANNING
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State | PA
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Zip | 16201-2409
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Country | US
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Telephone | 724-548-4801
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Fax | 724-548-4801
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Provider Business Mailing Address
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Address Line | 141 S JEFFERSON ST
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City | KITTANNING
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State | PA
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Zip | 16201-2409
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Country | US
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Telephone | 724-548-4801
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Fax | 724-548-4801
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Authorized Official
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Title or Position | OWNER
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Name | JAMIE S BONATCH
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Credential |
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Telephone | 724-548-4801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | FO3029
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License Number State | PA
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