Individual
ANGELO BONGIORNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1 UNIVERSITY BLVD, SAINT LOUIS, MO 63121-4400
(314) 516-5686
Mailing address
1 UNIVERSITY BLVD, SAINT LOUIS, MO 63121-4400
(314) 516-5686
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2014028839
MO
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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