Provider Demographics
NPI:1285830836
Name:WILLIAMSON, BONNIE L (DC)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:L
Last Name:WILLIAMSON
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 1:43 PEARSON FALLS RD
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:NC
Mailing Address - Zip Code:28773-9772
Mailing Address - Country:US
Mailing Address - Phone:828-749-3875
Mailing Address - Fax:828-749-3876
Practice Address - Street 1:43 PEARSON FALLS RD
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:NC
Practice Address - Zip Code:28773-9772
Practice Address - Country:US
Practice Address - Phone:828-749-3875
Practice Address - Fax:828-749-3876
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2008-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3143111N00000X
SC2749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC245790Medicare PIN