Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 394OPT | MT |
NPI | 1346359155 |
---|---|
Provider Name | Dr. Harvey Bonner |
First Address | Billings, MT 59102-6425 |
Second Address | Billings, MT 59102-6425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |