Bohn Gilbride, PTA

Individual provider Active NPI Physical Therapy Assistant · Rochester, MA

NPI 1700487261 · NPPES record last updated Nov 2, 2020

Key facts

NPI
1700487261
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
9714 (MA)
Practice address
66 Mendell Rd
Rochester, MA 02770-2001
Phone
(907) 406-0816
NPI assigned
Nov 2, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
9714MAMDProsthodontist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
225200000X 9714 MA Yes

Addresses

Primary practice location

66 Mendell Rd
Rochester, MA 02770-2001

Mailing address

66 Mendell Rd
Rochester, MA 02770-2001
Phone (907) 406-0816

Other providers in Rochester, MA

All providers in Rochester, MA · Physical Therapy Assistant in Massachusetts

Sources for this page

Verify at the official NPI Registry.