RANDALL BONNOM

LONGMONT, CO
NPI1588110860
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CO  ACB.0008050)
Enumeration Date2016-08-28
Last Update Date2016-08-28
Business Address
RANDALL BONNOM
420 21ST AVE #113
LONGMONT, CO 80501
Phone number: 303-834-9369
Mailing Address
RANDALL BONNOM
420 21ST AVE #113
LONGMONT, CO 80501
Phone number: 303-834-9369
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