Provider Demographics
NPI:1043997695
Name:BOK BOK THERAPY, LLC
Entity Type:Organization
Organization Name:BOK BOK THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-335-6912
Mailing Address - Street 1:270 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-3818
Mailing Address - Country:US
Mailing Address - Phone:770-335-6912
Mailing Address - Fax:
Practice Address - Street 1:1060 GAINES SCHOOL RD STE A2
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-3100
Practice Address - Country:US
Practice Address - Phone:770-335-6912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty