| Doctor Name: | SALLY BODENSTEINER |
| NPI Number: | 1851580823 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | MD2008-0602 |
| Business Practice Address: | 406 N 1st St Vincennes, IN - 475911340 |
| Business Phone Number: | 8128821106 |
| Business Fax Number: | 8128852758 |
| Mailing Address: | 406 N 1st St, VINCENNES |
| State: | IN |
| Postal Code: | 475911340 |
| Phone Number: | 8128821106 |
| Fax Number: | 8128852758 |
| NPI Enumeration Date: | 10/16/2007 |
| NPI Last Update Date: | 05/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD2008-0602 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |