Individual
KENNA BONDOC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
500 E 3RD ST, RUSSELLVILLE, AR 72801-5204
(479) 968-1198
(479) 967-1178
Mailing address
3345 HOMESTEAD RD, CONWAY, AR 72032-9148
(870) 820-1431
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
O-T1370
AR
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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