Provider Demographics
NPI:1720693294
Name:BONAS, BRITTLYN JOY (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRITTLYN
Middle Name:JOY
Last Name:BONAS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3028 W WALTANN LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-4015
Mailing Address - Country:US
Mailing Address - Phone:480-310-1793
Mailing Address - Fax:
Practice Address - Street 1:7310 N 16TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5259
Practice Address - Country:US
Practice Address - Phone:602-535-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31432225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist