Provider Demographics
NPI:1336444652
Name:BONIFER, NANCY (PT, DPT, MS)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BONIFER
Suffix:
Gender:F
Credentials:PT, DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 S PIERCE ST # 320
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4552
Mailing Address - Country:US
Mailing Address - Phone:303-872-7240
Mailing Address - Fax:303-872-7240
Practice Address - Street 1:6901 S PIERCE ST # 320
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-4552
Practice Address - Country:US
Practice Address - Phone:303-872-7240
Practice Address - Fax:303-872-7240
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist