Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 01046691 | IN |
NPI | 1184713026 |
---|---|
Provider Name | Dr. Bonnie Lee Houff |
First Address | Bloomington, IN 47405-3190 |
Second Address | Bloomington, IN 47405-3190 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |