# MARTIN S. BOHM, D.O., PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Alpine Meadows Medical Clinic, PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255513677
- **Authorized official:** DR. MARTIN SCOTT BOHM D.O. (PHYSICIAN)
- **Authorized official phone:** (970) 776-1950

## Contact information

- **Practice address:** 2802 MADISON SQUARE DR, SUITE 120, LOVELAND, CO 80538-3387
- **Practice address phone:** (970) 776-1950
- **Practice address fax:** (970) 776-1954
- **Mailing address:** 2802 MADISON SQUARE DR, SUITE 120, LOVELAND, CO 80538-3387
- **Mailing address phone:** (970) 776-1950
- **Mailing address fax:** (970) 776-1954

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | CO | Yes |

## Other

- **Enumeration date:** 11/27/2007
- **Last updated:** 12/03/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 44910 | COLORADO STATE LICENSE | CO |
| 05 | — | 70123012 | — | CO |