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1770332280
JOHVANI E BANTILES
WATERTOWN, NY
NPI
1770332280
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Entity Type
Individual
Gender
N/A
Sole Proprietor ?
No
Primary Taxonomy
163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent
(Licence: NY 915663)
Enumeration Date
2024-05-16
Last Update Date
2024-10-03
Business Address
JOHVANI E BANTILES
650 STATE ST
WATERTOWN, NY 13601-2839
Phone number: 315-755-1251
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Mailing Address
JOHVANI E BANTILES
720 MILL ST APT 1
WATERTOWN, NY 13601-1566
Phone number: 315-775-7649
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