Individual
SUSAN S BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2276 GEORGE WASHINGTON MEMORIAL HWY, HAYES, VA 23072-3559
(804) 642-8776
Mailing address
PO BOX 187, GWYNN, VA 23066-0187
(804) 725-1613
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840847
VA
Other
Enumeration date
08/15/2008
Last updated
08/15/2008
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