Individual
CODY LUCAS BONTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1200 W UNIVERSITY AVE, MITCHELL, SD 57301-4358
(605) 995-2600
Mailing address
212 W ELM AVE, MITCHELL, SD 57301-3311
(605) 321-0264
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2000029735
SD
Other
Enumeration date
07/12/2017
Last updated
07/12/2017
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