Boho Pain Management and Rehabilitation LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

919-026 Issued in WI

Legal business name

BOHO PAIN MANAGEMENT AND REHABILITATION LLC

Practice address

3701 Durand Ave
Racine, WI 53405-4458

Phone

(262) 497-8798

Fax

(262) 554-6354

NPI assigned

Apr 13, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David John Boho, O.T.R.

Title

President and Owner

Phone

(262) 497-8798

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1356584932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 LINDA LN",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534054827",
            "telephone_number": "262-554-9465",
            "fax_number": "262-554-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 DURAND AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534054458",
            "telephone_number": "262-497-8798",
            "fax_number": "262-554-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOHO PAIN MANAGEMENT AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "BOHO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT AND OWNER",
        "authorized_official_telephone_number": "262-497-8798",
        "authorized_official_credential": "O.T.R."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "WI",
            "license": "919-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Malaina Blank, OTR L
• Elaine Marie Blank, LPN
• Benjamin P. Bodven, PTA
• Jennifer L Boerger, FNP APNP
• Lisa D Boerner, PHARMD
• Patricia S. Bolling, N.P.
• Glen Bordak, M.D.
• Craig John Borgardt, RPH
• Paige Borst
• Anna Marie Bort, LPN

• Rehabilitation Clinic/Center in Racine, WI
• Providers in Racine, WI by specialty
• Rehabilitation Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.