Provider Demographics
NPI:1306270889
Name:BONNAR, BRIAN PETER (LAT, ATC)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:PETER
Last Name:BONNAR
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7436
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-0436
Mailing Address - Country:US
Mailing Address - Phone:412-648-8349
Mailing Address - Fax:
Practice Address - Street 1:ALLIQUIPPA AND DARRAGH STS.
Practice Address - Street 2:FITZGERALD FIELD HOUSE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-0436
Practice Address - Country:US
Practice Address - Phone:412-648-8349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0032042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer