Provider Demographics
NPI:1063397610
Name:BONILLA LAMBOY, FREDDIE JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:FREDDIE
Middle Name:JOSEPH
Last Name:BONILLA LAMBOY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 TIMM WAY APT I204
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-2185
Mailing Address - Country:US
Mailing Address - Phone:787-298-8940
Mailing Address - Fax:
Practice Address - Street 1:550 THORNTON PKWY UNIT 178
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-2166
Practice Address - Country:US
Practice Address - Phone:303-254-8430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008953111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor