Individual
JOE BONAZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1508 BIGLEY AVE STE A, CHARLESTON, WV 25302-3904
(304) 935-1069
Mailing address
1508 BIGLEY AVE STE A, CHARLESTON, WV 25302-3904
(304) 935-1069
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
73481
WV
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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