Most Relevant Information
Provider Data
| NPI Number: | 1003497140 |
| Provider Name: | BONNIE KNOTTS |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/20/2021 |
| Last Updated: | 04/20/2021 |
Provider Practice Location
34 MEDICAL PARK BLVD STE A
PETERSBURG
VA
238059283
Practice Location Phone/Fax
| Phone: | 8046090175 |
| Fax: |
Provider Mailing Location
34 MEDICAL PARK BLVD STE A
PETERSBURG
VA
238059283
Provider Mailing Phone/Fax
| Phone: | 8046090175 |
| Fax: |