Most Relevant Information
Provider Data
| NPI Number: | 1003197930 |
| Provider Name: | BONNIE JILL WEISSMAN P.T.A. |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: | AT595 |
Most Important Dates
| Enumeration Date: | 09/06/2011 |
| Last Updated: | 09/06/2011 |
Provider Practice Location
5601 DE SOTO AVE
WOODLAND HILLS
CA
913676701
Practice Location Phone/Fax
| Phone: | 8187193958 |
| Fax: |
Provider Mailing Location
PO BOX 3627
GRANADA HILLS
CA
913940627
Provider Mailing Phone/Fax
| Phone: | 8183680619 |
| Fax: |