Healthcare Provider Details
I. General information
NPI: 1861836470
Provider Name (Legal Business Name): DEBRA ANN BONDS CERTIFIED HAIR LOSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/25/2013
Last Update Date: 04/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8010 PARALLEL PKWY
KANSAS CITY KS
66112-2009
US
IV. Provider business mailing address
8010 PARALLEL PKWY
KANSAS CITY KS
66112-2009
US
V. Phone/Fax
- Phone: 816-674-2556
- Fax:
- Phone: 816-674-2556
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1744P3200X |
| Taxonomy | Prosthetics Case Management |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: