Regina Sue Bonnell, LMT
Technician, Other in Rockford, IL. Individual provider (NPI-1).
NPI number1568803237
StatusActive
Last updated in NPPESJul 10, 2013
Details
- NPI
- 1568803237
- Entity type
- Individual (NPI-1)
- Name
- Ms. Regina Sue Bonnell
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 10, 2013
- Last updated
- Jul 10, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
6905 E State StRockford, IL 61108-2692
Phone 815-397-4142
Mailing address
Po Box 6107Rockford, IL 61125-1107
Phone 815-397-4142
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