Individual
COURTNEY BONILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23249-0001
(804) 675-5000
Mailing address
15803 ROLAND VIEW DR, CHESTER, VA 23831-7246
(757) 710-3083
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
949152
VA
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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