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NPI Code Detail

MEDICARE: BONNIE K COLBY

MEDICARE: BONNIE K COLBY
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
1225100000XPhysical Therapist3729NH

General Provider Information

NPI Number : 1588900922
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE K COLBY
Provider Business Mailing Address
First Line : PO BOX 126
Second Line :
City : MOULTONBORO
State : NH
Zip : 03254-0126
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 790 LAKE ST
Second Line :
City : BRISTOL
State : NH
Zip : 03222-4548
Country : US
Telephone Number : 603-744-0275
Fax Number : 603-744-9378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2012
Last Update Date : 12/12/2012

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Directions to “ BONNIE K COLBY ” Practice Location

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