CHARLES EDWARD BONFANTI

TAOS, NM
NPI1295792570
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NM  75-PA002)
Enumeration Date2006-04-28
Last Update Date2017-02-03
Business Address
-- CHARLES EDWARD BONFANTI PA
630 PASEO DEL PUEBLO SUR SUITE 150
TAOS, NM 87571-6070
Phone number: 575-758-3005
Mailing Address
-- CHARLES EDWARD BONFANTI PA
PO BOX 158 SUITE 150
ESPANOLA, NM 87532-0158
Phone number: 505-753-7218
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