Provider Demographics
NPI:1508943101
Name:BOHLING, PAMELA (PT, OCS)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:BOHLING
Suffix:
Gender:F
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10833 W 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-4792
Mailing Address - Country:US
Mailing Address - Phone:303-422-9519
Mailing Address - Fax:
Practice Address - Street 1:7777 W 38TH AVE UNIT A120
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6170
Practice Address - Country:US
Practice Address - Phone:303-423-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO3324OtherLICENSE#