Kevin Bohl

Individual provider Active NPI Physical Therapist · Las Vegas, NV

NPI 1275292005 · NPPES record last updated Dec 9, 2021

Key facts

NPI
1275292005
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
4370 Blue Diamond Rd Ste 100
Las Vegas, NV 89139-7787
Phone
(702) 443-9301
NPI assigned
Dec 9, 2021
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4720NVMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

4370 Blue Diamond Rd Ste 100
Las Vegas, NV 89139-7787

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Physical Therapist in Nevada

Sources for this page

Verify at the official NPI Registry.