IndividualActive
Shanda Bonner
NPI 1609207893 · Contractor · Saint Louis, MO
Provider details
- NPI number
- 1609207893
- Entity type
- Individual
- Primary specialty
- ContractorOther Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
1504 Park Way Dr
Saint Louis, MO 63130-1245
Phone: (314) 449-4946
Fax: (314) 449-4946
Approximate (ZIP-level) locationGet directions
Mailing address
1504 Park Way Dr
Saint Louis, MO 63130-1245
Registry dates
- Enumerated
- 2013-12-12
- Last updated
- 2013-12-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.