WANDA BONTRAGER

GOSHEN, IN
NPI1093090730
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy314000000X Skilled Nursing Facility
(Licence: IN  31000534A)
Enumeration Date2011-10-13
Last Update Date2011-10-13
Business Address
-- WANDA BONTRAGER
404 MOUNT VERNON DR
GOSHEN, IN 46526-1432
Phone number: 574-533-4933
Mailing Address
-- WANDA BONTRAGER
404 MOUNT VERNON DR
GOSHEN, IN 46526-1432
Phone number:
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