Individual
KELLY BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2509 COUNTY HIGHWAY I, CHIPPEWA FALLS, WI 54729-2785
(715) 717-7455
Mailing address
2661 COUNTY HIGHWAY I, CHIPPEWA FALLS, WI 54729-5407
(715) 717-7455
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1732-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40449300
—
WI
Enumeration date
01/16/2006
Last updated
03/17/2018
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