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General NPI Number Information
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NPI Number | 1083908123
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Entity Type | Organization
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Legal Business Name | BONITA HEALTH & HEALING CORP
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 28331 S TAMIAMI TRL SUITE 2
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-3215
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Country | US
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Telephone | 239-676-7269
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Fax | 239-676-7275
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Provider Business Mailing Address
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Address Line | 28331 SOUTH TAMIAMI TRAIL SUITE 2
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City | BONITA SPRINGS
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State | FL
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Zip | 33134
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Country | US
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Telephone | 239-676-7269
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. MARY ANN ZAWADA
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Credential | CHIROPRACTOR
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Telephone | 239-676-7269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | MM 26978
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License Number State | FL
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