Individual
JOHN BONAVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
431 RIVER ST STE 4, WALTHAM, MA 02453-5483
(781) 314-1000
(781) 314-1001
Mailing address
210 COMMERCE WAY STE 150, PORTSMOUTH, NH 03801-8203
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23128
MA
Other
Enumeration date
08/14/2017
Last updated
08/14/2017
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