Individual
MR. RICHARD ANTHONY BONOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT ASSISTANT
Contact information
Practice address
2315 STOCKTON BLVD, SACRAMENTO, CA 95817-2201
(916) 734-7040
Mailing address
555 DEVONSHIRE DR, DIXON, CA 95620-2323
(707) 693-0570
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4256
CA
Other
Enumeration date
06/20/2006
Last updated
07/08/2007
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