Individual
CAROL LANCASTER BONELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1 DIANE DR, FORT ASHBY, WV 26719
(304) 298-3602
Mailing address
15200 BRANDYWINE DR SW, CUMBERLAND, MD 21502-5817
(301) 729-6588
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
14785
MD
225100000X
Physical Therapist
Primary
2420
WV
Other
Enumeration date
12/28/2012
Last updated
12/28/2012
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