Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 4370 | OH |
N | 111NP0017X | Pediatric Chiropractor | DC0000002618 | TN |
NPI | 1639419989 |
---|---|
Provider Name | Dr. Allison M Bonham |
First Address | Centerville, OH 45459-2753 |
Second Address | Centerville, OH 45459-2753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2013 |
Last Update Date | 04/03/2013 |