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Individual

MARLENE BONILLA ALICEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
6625 LYNDALE AVE S STE 105, RICHFIELD, MN 55423-2673
(612) 788-8778
Mailing address
6625 LYNDALE AVE S STE 300, RICHFIELD, MN 55423-2491
(612) 788-8778
(612) 869-3473

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1016
MN
213E00000X
Podiatrist
N006419-1
NY

Other

Enumeration date
08/14/2007
Last updated
04/12/2023
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