Provider Demographics
NPI:1295234557
Name:BOHR, ZACHARY (DPT)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:BOHR
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 1:14515 NORTH OUTER 40 RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5791
Mailing Address - Country:US
Mailing Address - Phone:314-434-8680
Mailing Address - Fax:
Practice Address - Street 1:3899 VETERANS MEMORIAL PKWY # A2
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6425
Practice Address - Country:US
Practice Address - Phone:636-922-9933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018003403225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist