Provider Demographics
NPI:1184883639
Name:HILL, BONNY (LMT)
Entity type:Individual
Prefix:
First Name:BONNY
Middle Name:
Last Name:HILL
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 1:372 ELLEN DR
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1323
Mailing Address - Country:US
Mailing Address - Phone:716-626-0232
Mailing Address - Fax:716-565-1594
Practice Address - Street 1:372 ELLEN DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-1323
Practice Address - Country:US
Practice Address - Phone:716-626-0232
Practice Address - Fax:716-565-1594
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014455225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist