Individual
MS. BONNIE K BEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2047 22ND AVE, KENOSHA, WI 53140-4602
(262) 551-9400
(262) 551-9416
Mailing address
2047 22ND AVE, KENOSHA, WI 53140-4602
(262) 551-9400
(262) 551-9416
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1519-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1519-024
PT LICENSE
WI
01
—
391313084017
ANTHEM BLUE SHIELD
WI
05
—
40014000
—
WI
Enumeration date
07/16/2007
Last updated
04/06/2008
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