Individual
JACQUELINE BONOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
380 LONG COVE DR, HILTON HEAD, SC 29928-6143
(843) 645-2668
(667) 887-7789
Mailing address
380 LONG COVE DR, HILTON HEAD, SC 29928-6143
(843) 645-2668
(866) 788-7789
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10200
SC
Other
Enumeration date
11/09/2006
Last updated
06/15/2020
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