Provider Demographics
NPI:1972710325
Name:BODNAR, KAREN KOTWICA (DC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:KOTWICA
Last Name:BODNAR
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 1:10229 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-2310
Mailing Address - Country:US
Mailing Address - Phone:440-543-5865
Mailing Address - Fax:
Practice Address - Street 1:45 N CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-8702
Practice Address - Country:US
Practice Address - Phone:330-562-3142
Practice Address - Fax:330-995-0230
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2479111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor