Provider Demographics
NPI:1669082608
Name:BOHN, SUZANNE STENGEL (DPT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:STENGEL
Last Name:BOHN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UMPAWAUG RD
Mailing Address - Street 2:
Mailing Address - City:WEST REDDING
Mailing Address - State:CT
Mailing Address - Zip Code:06896-1212
Mailing Address - Country:US
Mailing Address - Phone:203-788-4451
Mailing Address - Fax:
Practice Address - Street 1:10B ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2100
Practice Address - Country:US
Practice Address - Phone:203-778-0720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT011748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist