Individual
EDWARD ANDREW BONIECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT/L
Contact information
Practice address
901 SW HIGGINS AVE, MISSOULA, MT 59803-3600
(406) 214-2606
(406) 213-0073
Mailing address
PO BOX 171, FLORENCE, MT 59833-0171
(406) 273-9038
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
803
MT
Other
Enumeration date
01/18/2007
Last updated
09/08/2021
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