Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 1711 | OR |
Y | 175F00000X | Naturopath | AHC-NAT-LIC-801 | MT |
NPI | 1093044968 |
---|---|
Provider Name | Dr. Alisun Cummings Bonville |
First Address | Bozeman, MT 59719-0651 |
Second Address | Bozeman, MT 59718-7083 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2009 |
Last Update Date | 29/10/2013 |