Organization
THE BONIN CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OTTO JOSEPH BONIN NP (OWNER)
(225) 570-2010
Entity
Organization
Contact information
Practice address
1215 INDEPENDENCE BLVD, 1A, ZACHARY, LA 70791-7390
(225) 570-2010
(225) 570-8573
Mailing address
1215 INDEPENDENCE BLVD, 1A, ZACHARY, LA 70791-7390
(225) 570-2010
(225) 570-8573
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
AP04429
LA
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
11/20/2015
Last updated
07/08/2024
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