| NPI | 1417308420 |
|---|---|
| Former Name | NICOLE BOHN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: UT 9808065-2401) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2014026904) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2016-06-30 |