Individual
BONITA REX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4800 FILLMORE TER APT G11, PHILADELPHIA, PA 19124-2465
(267) 234-5440
Mailing address
4800 FILLMORE TER APT G11, PHILADELPHIA, PA 19124-2465
(267) 234-5440
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT127720
TX
225700000X
Massage Therapist
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Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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