Provider Demographics
NPI:1326330788
Name:CRAIG, BONNIE HEATHER (PT)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:HEATHER
Last Name:CRAIG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 TURTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3152
Mailing Address - Country:US
Mailing Address - Phone:828-274-2188
Mailing Address - Fax:828-274-7843
Practice Address - Street 1:21 TURTLE CREEK DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3152
Practice Address - Country:US
Practice Address - Phone:828-274-2188
Practice Address - Fax:828-274-7843
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6394225100000X
NC14769225100000X
NC446342251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic