Provider Demographics
NPI:1861764557
Name:BONTE-CHUN, BRIDGETT ANN (DPT)
Entity type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:ANN
Last Name:BONTE-CHUN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRIDGETT
Other - Middle Name:ANN
Other - Last Name:BONTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4200 DAHLBERG DR STE 300
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4841
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:
Practice Address - Street 1:4100 MINNESOTA DR
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5417
Practice Address - Country:US
Practice Address - Phone:952-456-7000
Practice Address - Fax:952-456-7598
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60214145225100000X, 225100000X
MN9587225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist