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General NPI Number Information
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NPI Number | 1376688101
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Entity Type | Individual
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Provider Name | SANDRA KATARINA BON-BEAM DC
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 55 SCHANCK RD STE B-19
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City | FREEHOLD
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State | NJ
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Zip | 07728-3067
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Country | US
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Telephone | 732-294-0004
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Fax | 732-294-0438
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Provider Business Mailing Address
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Address Line | 602 CANDLEWOOD CMNS
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City | HOWELL
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State | NJ
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Zip | 07731-2173
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Country | US
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Telephone | 732-901-3001
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Fax | 732-901-3105
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00475200
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License Number State | NJ
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