Healthcare Provider Details

I. General information

NPI: 1760395065
Provider Name (Legal Business Name): BOEHMER WELLNESS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 LINCOLN AVE
SHEBOYGAN WI
53081-2862
US

IV. Provider business mailing address

404 LINCOLN AVE
SHEBOYGAN WI
53081-2862
US

V. Phone/Fax

Practice location:
  • Phone: 608-475-9801
  • Fax:
Mailing address:
  • Phone: 608-475-9801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC BOEHMER
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 608-475-9801