Provider Demographics
NPI:1700595055
Name:BOHREN, TAMARA (DC)
Entity Type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:
Last Name:BOHREN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-2217
Mailing Address - Country:US
Mailing Address - Phone:619-537-6833
Mailing Address - Fax:
Practice Address - Street 1:724 PEARL ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5006
Practice Address - Country:US
Practice Address - Phone:303-449-3103
Practice Address - Fax:303-402-1095
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35114111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor