Individual
DR. GENDIA MARIE BONVILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1109 DICKORY AVE APT B315, RIVER RIDGE, LA 70123-2278
(504) 284-8628
Mailing address
1109 DICKORY AVE APT B315, RIVER RIDGE, LA 70123-2278
(504) 284-8628
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1930
LA
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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