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1295245421
ELIZABETH BONANNI
MOSCOW, ID
NPI
1295245421
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2017-10-02
Last Update Date
2017-10-02
Business Address
ELIZABETH BONANNI ATC
875 PERIMETER DR # MS 2302
MOSCOW, ID 83844-9803
Phone number: 540-604-7818
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Mailing Address
ELIZABETH BONANNI ATC
301 LAUDER AVE APT 204
MOSCOW, ID 83843-4401
Phone number: 540-604-7818
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