Provider Demographics
NPI:1578525846
Name:BOHLMAN, SHERI (PT)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:BOHLMAN
Suffix:
Gender:F
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:W239N1812 ROCKWOOD DR STE 100
Mailing Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES INC.
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1113
Mailing Address - Country:US
Mailing Address - Phone:262-523-0310
Mailing Address - Fax:
Practice Address - Street 1:17700 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-2006
Practice Address - Country:US
Practice Address - Phone:262-781-3083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5680225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40441100Medicaid
WI683750026Medicare PIN
WI40441100Medicaid
WI81030Medicare PIN