Individual
MRS. TARA JENNIFER BONVILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
3005 47TH STREET, SUITE F-2, BOULDER, CO 80301
(303) 440-0979
(303) 440-0993
Mailing address
3005 47TH STREET, SUITE F-2, BOULDER, CO 80301
(303) 440-0979
(303) 440-0993
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5423
CO
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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