Individual
MR. STEVEN BONHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
385 NAIL RD, APT B-21, SOUTHAVEN, MS 38671-8853
(870) 897-9503
Mailing address
385 NAIL RD, APT B-21, SOUTHAVEN, MS 38671-8853
(870) 897-9503
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2173AR
AR
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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