Provider Demographics
NPI:1740368182
Name:BOHLAND, VALERIE JOY (DC)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:JOY
Last Name:BOHLAND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:VALERIE
Other - Middle Name:JOY
Other - Last Name:BOHLAND-REIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3939 JODECO RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-5477
Mailing Address - Country:US
Mailing Address - Phone:770-898-9888
Mailing Address - Fax:770-898-5758
Practice Address - Street 1:3939 JODECO RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-5477
Practice Address - Country:US
Practice Address - Phone:770-898-9888
Practice Address - Fax:770-898-5758
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3740-012111NI0013X
GACHIR005293111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU55500Medicare UPIN
GAU55500Medicare UPIN