Provider Demographics
NPI:1255182879
Name:FRAHM, BOGAN (DPT)
Entity type:Individual
Prefix:DR
First Name:BOGAN
Middle Name:
Last Name:FRAHM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20321 STERLING BAY LN W APT B
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-4947
Mailing Address - Country:US
Mailing Address - Phone:208-640-3248
Mailing Address - Fax:
Practice Address - Street 1:19607 W CATAWBA AVE STE 102
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-4042
Practice Address - Country:US
Practice Address - Phone:704-625-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP22307225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist