MRS. Tara Bonham

NPI #1043579329 in Cedar City, Utah

Provider Information

NPI Number: 1043579329
Entity Type: Individual
Name: MRS. Tara Bonham
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: May 8, 2012
Last Updated: May 8, 2012

Practice Location

Address: 170 ALTAMIRA AVENUE
City: Cedar City
State: Utah
ZIP Code: 84720
Phone: (435) 586-0213

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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