Provider Demographics
NPI:1407043938
Name:BOEHME, SHARON EILEEN
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:EILEEN
Last Name:BOEHME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 467 BOX 1078
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:GERMANY
Mailing Address - Zip Code:09096
Mailing Address - Country:DE
Mailing Address - Phone:0619-857-5922
Mailing Address - Fax:
Practice Address - Street 1:CMR 402
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:GERMANY
Practice Address - Zip Code:09180
Practice Address - Country:DE
Practice Address - Phone:49619-857-5922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004789225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist