IndividualActive
Bonita Despain, PTA
NPI 1588033658 · Physical Therapy Assistant · International Falls, MN
Provider details
- NPI number
- 1588033658
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- No
- License
- 2015026804 (MO)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
2201 Keenan Dr
International Falls, MN 56649-2152
Phone: (218) 283-8313
Approximate (ZIP-level) locationGet directions
Mailing address
422 7th St # 1
International Falls, MN 56649-2619
Registry dates
- Enumerated
- 2015-09-18
- Last updated
- 2022-05-25
- Certified
- 2022-05-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.