Individual
BONNIE L. GUNCKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD LD
Contact information
Practice address
4210 FLAGSTAFF CV, FORT WAYNE, IN 46815-4417
(260) 489-9009
(260) 489-5057
Mailing address
4210 FLAGSTAFF CV, FORT WAYNE, IN 46815-4417
(260) 489-9009
(260) 489-5057
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2001
OH
133V00000X
Registered Dietitian
Primary
37000176A
IN
Other
Enumeration date
06/11/2006
Last updated
12/17/2008
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