NPI 1073301453

Juan Mejia-Bonilla

Practitioner Driver Willmar, MN

Practice location

Address: 313 Litchfield Ave SW, Willmar, MN 56201-3352
Phone: (320) 894-4265

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence N874-116-786-919 (MN)

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Registry record

NPI: 1073301453
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Apr 2025
Record last updated: 28 Apr 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.