Healthcare Provider Details

I. General information

NPI: 1447242615
Provider Name (Legal Business Name): STEVEN SCOTT BONT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 N ADAMS ST
SAINT CROIX FALLS WI
54024-9176
US

IV. Provider business mailing address

PO BOX 579
SAINT CROIX FALLS WI
54024-0579
US

V. Phone/Fax

Practice location:
  • Phone: 715-483-3913
  • Fax: 715-483-3098
Mailing address:
  • Phone: 715-483-3913
  • Fax: 715-483-3098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2237
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: