Provider Demographics
NPI:1053685842
Name:BOND, COURTNEY DIANA (DC)
Entity Type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:DIANA
Last Name:BOND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SOUTH JEFFERSON AVE.
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1555
Mailing Address - Country:US
Mailing Address - Phone:724-745-3737
Mailing Address - Fax:724-745-0460
Practice Address - Street 1:1 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1555
Practice Address - Country:US
Practice Address - Phone:724-745-3737
Practice Address - Fax:724-745-0460
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010550111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor