Provider Demographics
NPI:1891440251
Name:BOND, CONNIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:
Last Name:BOND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4980 S ALMA SCHOOL RD STE 2-294
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-5545
Mailing Address - Country:US
Mailing Address - Phone:858-829-3121
Mailing Address - Fax:
Practice Address - Street 1:4730 E WARNER RD STE 5
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-3320
Practice Address - Country:US
Practice Address - Phone:858-829-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-24541225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist