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Individual
JEAN L BOHANAN
Active
Individual
JEAN L BOHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006742L
PA
2251P0200X
Pediatric Physical Therapist
PT006742L
PA
Other
Enumeration date
08/12/2009
Last updated
08/23/2023
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