DEREK LANCE BOHM

CHICAGO, IL
NPI1437940186
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2025-05-13
Last Update Date2025-05-13
Business Address
DEREK LANCE BOHM Physician Assistant
606 W CORNELIA AVE APT 489
CHICAGO, IL 60657-2546
Phone number: 435-890-8661
Mailing Address
DEREK LANCE BOHM Physician Assistant
606 W CORNELIA AVE APT 489
CHICAGO, IL 60657-2546
Phone number: 435-890-8661