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NPI Code Detail

MEDICARE: MRS. AMY BONKOSKI MT

MEDICARE: MRS. AMY BONKOSKI MT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMT.0010652CO
2225700000XMassage TherapistMT12103SD

General Provider Information

NPI Number : 1366784894
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY BONKOSKI MT
Provider Business Mailing Address
First Line : 904 QUINCY ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-2608
Country : US
Telephone Number : 605-716-0646
Fax Number :
Provider Business Practice Location Address
First Line : 904 QUINCY ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-2608
Country : US
Telephone Number : 605-716-0646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2013
Last Update Date : 12/09/2024

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Directions to “ MRS. AMY BONKOSKI MT” Practice Location

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