Provider Demographics
NPI:1366459919
Name:BOHMILLER, ADAM (PT)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:BOHMILLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 CHIEF JUSTICE CUSHING HWY
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025
Mailing Address - Country:US
Mailing Address - Phone:781-383-8001
Mailing Address - Fax:781-383-8009
Practice Address - Street 1:790 CHIEF JUSTICE CUSHING HWY
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025
Practice Address - Country:US
Practice Address - Phone:781-383-8001
Practice Address - Fax:781-383-8009
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17562225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist