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General NPI Number Information
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NPI Number | 1770763914
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Entity Type | Organization
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Legal Business Name | BOHN PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 20101 PEACHLAND BLVD STE. 204
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-2180
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Country | US
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Telephone | 941-624-6491
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Fax |
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Provider Business Mailing Address
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Address Line | 20101 PEACHLAND BLVD STE. 204
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-2180
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Country | US
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Telephone | 941-624-6491
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. MABEL CUNANAN
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Credential | PT
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Telephone | 941-624-6491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9925
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License Number State | FL
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