MICHAEL THOMAS BONACUSO

EAST WILLISTON, NY
NPI1245728013
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date2018-04-27
Last Update Date2018-04-27
Business Address
MICHAEL THOMAS BONACUSO ATC
15 SHADOW LN
EAST WILLISTON, NY 11596-2510
Phone number: 516-384-4354
Mailing Address
MICHAEL THOMAS BONACUSO ATC
15 SHADOW LN
EAST WILLISTON, NY 11596-2510
Phone number: 516-384-4354