Individual
NICOLE MIA BONACORSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 S STATE ST, ANN ARBOR, MI 48109-2203
(408) 761-6632
Mailing address
230 BOARMAN ST, JACKSON, CA 95642-2510
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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