Individual
TANNER BONHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8901 E ORME ST, WICHITA, KS 67207-2473
(316) 641-3548
Mailing address
8901 E ORME ST, WICHITA, KS 67207-2473
(316) 641-3548
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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