Provider Demographics
NPI:1801216460
Name:BOND, JEFFREY (LIC AC, DIPL AC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:BOND
Suffix:
Gender:M
Credentials:LIC AC, DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 FOREST SPRINGS DR SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-5616
Mailing Address - Country:US
Mailing Address - Phone:330-652-4979
Mailing Address - Fax:
Practice Address - Street 1:8790 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2360
Practice Address - Country:US
Practice Address - Phone:330-652-4979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist