Individual
BRIAN JAMES BONENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34 E AURORA RD, NORTHFIELD, OH 44067-2062
(330) 908-0203
Mailing address
160 N CHESTNUT ST, RAVENNA, OH 44266-2256
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA001297
OH
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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