Provider Demographics
NPI:1225065923
Name:BONHAM, ALAINA MARIE (MS, ATC, EMT-B)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:MARIE
Last Name:BONHAM
Suffix:
Gender:F
Credentials:MS, ATC, EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 COUNTY LINE RD W
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7295
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:859-233-8238
Practice Address - Street 1:584 COUNTY LINE RD W
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7295
Practice Address - Country:US
Practice Address - Phone:614-355-6398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH189403146N00000X
OHAT0034992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic