Provider Demographics
NPI:1447473996
Name:BONIC, EVE E (DC)
Entity type:Individual
Prefix:DR
First Name:EVE
Middle Name:E
Last Name:BONIC
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 1:12533 POSTGROVE DR APT S
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4582
Mailing Address - Country:US
Mailing Address - Phone:314-542-9546
Mailing Address - Fax:
Practice Address - Street 1:1851 SCHOETTLER RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5529
Practice Address - Country:US
Practice Address - Phone:636-227-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006038807111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology