Individual
BONNIE LUCILLE MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3016 PORTAGE AVE, SOUTH BEND, IN 46628-3501
(574) 272-9100
Mailing address
3016 PORTAGE AVE, SOUTH BEND, IN 46628-3501
(574) 272-9100
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004025A
IN
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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