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NPI Code Detail

MEDICARE: SCOTT ALAN BOHLIN

MEDICARE:   SCOTT ALAN BOHLIN
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
1101YA0400XAddiction (Substance Use Disorder) CounselorIA

General Provider Information

NPI Number : 1679325807
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT ALAN BOHLIN
Provider Business Mailing Address
First Line : 2574 280TH STREET SAC CITY IOWA 50583
Second Line :
City : SAC CITY
State : IA
Zip : 50583
Country : US
Telephone Number : 171-226-9318
Fax Number :
Provider Business Practice Location Address
First Line : 824 FLINDT DR STE 104
Second Line :
City : STORM LAKE
State : IA
Zip : 50588-3208
Country : US
Telephone Number : 800-242-5101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2024
Last Update Date : 04/02/2024

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Directions to “ SCOTT ALAN BOHLIN ” Practice Location

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