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Individual

BONNIE ASHLEY CANTU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
720 E DE LA ROSA ST, DEL RIO, TX 78840-6734
(830) 778-4500
Mailing address
309 MARY LOU DR APT A, DEL RIO, TX 78840-2763
(361) 542-0604

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT6742
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000025146
BOARD OF CERTIFICATION FOR ATHLETIC TRAINERS
TX
01
AT6742
TDLR
TX
Enumeration date
12/18/2017
Last updated
12/18/2017
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