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General NPI Number Information
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NPI Number | 1396870846
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Entity Type | Individual
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Provider Name | TOD OWEN BOEHM D.C., C.C.S.P.
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Gender | Male
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 2855 CHESAPEAKE BCH RD W
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City | DUNKIRK
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State | MD
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Zip | 20754-9530
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Country | US
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Telephone | 410-257-9762
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Fax | 410-257-9738
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Provider Business Mailing Address
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Address Line | 6549 LONG BEACH DR
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City | SAINT LEONARD
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State | MD
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Zip | 20685-2541
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | SO1535
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | SO1535
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License Number State | MD
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