Provider Demographics
NPI:1871795005
Name:BONNER, TERRI D (DC)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:D
Last Name:BONNER
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 1:3178 BERMUDA RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2421
Mailing Address - Country:US
Mailing Address - Phone:561-627-8464
Mailing Address - Fax:
Practice Address - Street 1:100 VILLAGE SQUARE XING STE 207
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4531
Practice Address - Country:US
Practice Address - Phone:561-627-8464
Practice Address - Fax:561-775-5655
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005873111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor