Individual
LANDYN PAIGE BONAMICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1370 JOHNSON AVE, BRIDGEPORT, WV 26330-1492
(304) 842-3330
Mailing address
1370 JOHNSON AVE, BRIDGEPORT, WV 26330-1492
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/18/2022
Last updated
07/01/2024
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