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Individual

MISS KIRBY E BONNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
600 REUNION CT, GRANBURY, TX 76048-1610
(817) 573-3773
Mailing address
3004 KAREN WAY, GRANBURY, TX 76049-2989
(304) 376-1812

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2075579
TX
225200000X
Physical Therapy Assistant
PTA001299
WV
225200000X
Physical Therapy Assistant
PTA21595
FL

Other

Enumeration date
07/03/2007
Last updated
07/17/2013
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