Autumn Bonner, DPT

Individual provider Active NPI Orthopedic Physical Therapist · Madison, WI

NPI 1609224989 · NPPES record last updated May 27, 2016

Key facts

NPI
1609224989
Entity type
Individual (NPI type 1)
Primary specialty
Orthopedic Physical Therapist 2251X0800X
License
13401-24 (WI)
Practice address
305 S Livingston St
Madison, WI 53703-3513
Phone
(608) 250-1775
NPI assigned
May 27, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 13401-24 WI Yes

Addresses

Primary practice location

305 S Livingston St
Madison, WI 53703-3513

Mailing address

1326 1/2 Vilas Ave
Madison, WI 53715-1552

Other providers in Madison, WI

All providers in Madison, WI · Orthopedic Physical Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.