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1093747164
BONAVENTURE J PORCO
MORGANTOWN, WV
NPI
1093747164
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: WV 27755)
Enumeration Date
2006-07-07
Last Update Date
2007-12-05
Business Address
BONAVENTURE J PORCO CRNA
1200 J D ANDERSON DR
MORGANTOWN, WV 26505-3494
Phone number: 304-243-3343
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Mailing Address
BONAVENTURE J PORCO CRNA
1 MEDICAL PARK
WHEELING, WV 26003-6379
Phone number: 304-243-3343
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