Individual
ASHLEE LYNN BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16601 S QUAIL RD, ODESSA, TX 79766-1368
(432) 634-5309
Mailing address
16601 S QUAIL RD, ODESSA, TX 79766-1368
(432) 634-5309
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2124093
TX
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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