Individual
DR. MARCO DIBONAVENTURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.P., PHD
Contact information
Practice address
1000 VALLEY FORGE CIR STE 105, KING OF PRUSSIA, PA 19406
(484) 392-7023
(484) 392-7877
Mailing address
1000 VALLEY FORGE CIR STE 105, KING OF PRUSSIA, PA 19406-4527
(484) 392-7023
(484) 392-7877
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AK001027
PA
171100000X
Acupuncturist
AP1018
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
593510229
TAX ID
FL
Enumeration date
01/22/2007
Last updated
08/08/2018
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