Provider Demographics
NPI:1609363381
Name:BOHEMIER, STEPHANE (DC)
Entity Type:Individual
Prefix:
First Name:STEPHANE
Middle Name:
Last Name:BOHEMIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4064 ALPINE AVE NW
Mailing Address - Street 2:STE B
Mailing Address - City:COMSTOCK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:49321-8909
Mailing Address - Country:US
Mailing Address - Phone:616-965-1197
Mailing Address - Fax:
Practice Address - Street 1:4064 ALPINE AVE NW
Practice Address - Street 2:STE B
Practice Address - City:COMSTOCK PARK
Practice Address - State:MI
Practice Address - Zip Code:49321-8909
Practice Address - Country:US
Practice Address - Phone:616-965-1197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010558111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor