Individual
BOBBY BONNER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1697PUTNUM DRIVE, CLARKSVILLE, TN 37042
(315) 489-5545
Mailing address
731 CHEATHAM ST., SPRINGFIELD, TN 37172
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
TN
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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