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NPI Code Detail

MEDICARE: KEVIN BOHL

MEDICARE:   KEVIN  BOHL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1275292005
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN BOHL
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4370 BLUE DIAMOND RD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89139-7787
Country : US
Telephone Number : 702-443-9301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2021
Last Update Date : 12/09/2021

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Directions to “ KEVIN BOHL ” Practice Location

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