Individual
MR. VIRGIL ERIC BONNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SSW
Contact information
Practice address
4921 NORTH BALD EAGLE DR., ENOCH, UT 84721
(435) 590-8672
Mailing address
4921 N BALD EAGLE DR, ENOCH, UT 84721-7103
(435) 590-8672
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8697053-3503
UT
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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