Individual
MRS. TARA BONHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
170 ALTAMIRA AVENUE, CEDAR CITY, UT 84720
(435) 586-0213
Mailing address
381 N 300 W, CEDAR CITY, UT 84721-3547
(435) 531-6105
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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