Individual
MR. JOHN RUSSELL BONNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.S.W.
Contact information
Practice address
4501 N UNIVERSITY AVE, PROVO, UT 84604-5504
(801) 227-2000
Mailing address
258 S 230 E, OREM, UT 84058-5526
(801) 205-5646
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4741940-3502
UT
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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