Individual
FAWN BOONSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
99 S. GOLD DR. SUITE 5, GOLDFIELD CARDIOVASCULAR INSTITUTE, APACHE JUNCTION, AZ 85120
(480) 962-0101
Mailing address
771 S CORNWALL DR, APACHE JUNCTION, AZ 85120-4812
(602) 206-2017
(480) 962-0202
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/28/2016
Last updated
06/24/2020
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