Doctor Name: | DR. CHERYL BONGIOVANNI |
NPI Number: | 1700824489 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD, RVT, CWS |
License Number: | CERTIFIED WOUND SPEC |
Business Practice Address: | 700 S J St Lakeview, OR - 976301623 |
Business Phone Number: | 5415175169 |
Business Fax Number: | 5419473339 |
Mailing Address: | Po Box 108, LAKEVIEW |
State: | OR |
Postal Code: | 976300105 |
Phone Number: | 5415175169 |
Fax Number: | 5419473339 |
NPI Enumeration Date: | 06/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | CERTIFIED WOUND SPEC |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |