Matt Bonander LLC
Physical Therapist in Krum, TX. Organization (NPI-2).
NPI number1154074201
StatusActive
Last updated in NPPESOct 1, 2024
Details
- NPI
- 1154074201
- Entity type
- Organization (NPI-2)
- Legal business name
- Matt Bonander LLC
- Organization subpart
- No
- Enumeration date
- Jan 29, 2022
- Certification date
- Oct 1, 2024
- Last updated
- Oct 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
| 225X00000X | Occupational Therapist | – | – |
Practice location
4118 Herdsman DrKrum, TX 76249-1556
Phone 940-535-8105
Mailing address
4118 Herdsman DrKrum, TX 76249-1556
Phone 940-535-8105
Authorized official
Matthew Ellis Bonander
Physical Therapist
9405358105
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