Healthcare Provider Details

I. General information

NPI: 1437083847
Provider Name (Legal Business Name): MICHAEL BOHM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 RICE BLVD
EXTON PA
19341-1383
US

IV. Provider business mailing address

163 POTTSTOWN PIKE
CHESTER SPRINGS PA
19425-9518
US

V. Phone/Fax

Practice location:
  • Phone: 610-424-1100
  • Fax:
Mailing address:
  • Phone: 610-424-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberTPT024083
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: