Ms Bonita Lynn Despain, PTA is a
Physical Therapy Assistant based in International Falls, Minnesota. Ms Bonita Lynn Despain is licensed to practice in Minnesota (license number A2779) and her current practice location is
2201 Keenan Dr, International Falls, Minnesota. She can be reached at her office (for appointments etc.) via phone at
(218) 283-8313.
NPI number for Ms Bonita Lynn Despain is 1588033658 and her current mailing address is 422 7th St # 1, International Falls, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1588033658.
Healthcare Provider's Profile
| Full Name | Ms Bonita Lynn Despain |
|---|
| Gender | Female |
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| Speciality | Physical Therapy Assistant |
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| Location | 2201 Keenan Dr, International Falls, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1588033658
- Provider Enumeration Date: 09/18/2015
- Last Update Date: 05/25/2022
Medical Identifiers
Medical identifiers for Ms Bonita Lynn Despain such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1588033658 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | 2015026804 (Missouri) | Secondary |
| 225200000X | Physical Therapy Assistant | 160.005650 (Illinois) | Secondary |
| 225200000X | Physical Therapy Assistant | A2779 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Bonita Lynn Despain is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Bonita Lynn Despain, PTA
422 7th St # 1,
International Falls, MN 56649-2619
Ph: (309) 502-1408 | Ms Bonita Lynn Despain, PTA
2201 Keenan Dr,
International Falls, MN 56649-2152
Ph: (218) 283-8313 |
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