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General NPI Number Information
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NPI Number | 1477737351
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Entity Type | Organization
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Legal Business Name | ROGER A BOHN DC PA
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 27970 CROWN LAKE BLVD SUITE #1
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4255
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Country | US
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Telephone | 239-947-3330
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Fax | 239-947-9493
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Provider Business Mailing Address
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Address Line | 27970 CROWN LAKE BLVD SUITE #1
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4255
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Country | US
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Telephone | 239-947-3330
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Fax | 239-947-9493
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AMY BOHN
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Credential |
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Telephone | 239-947-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH00004690
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License Number State | FL
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