Individual
KATELYN JEAN BOOHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1222 S PATTERSON BLVD, STE 220, DAYTON, OH 45402-2684
(937) 223-5350
(937) 224-3112
Mailing address
725 UNIVERSITY BLVD, DAYTON, OH 45435-0001
(937) 245-7100
(937) 245-7999
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-011518
OH
207RI0200X
Infectious Disease Physician
Primary
35-011518
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0121909
—
OH
Enumeration date
03/18/2010
Last updated
06/29/2015
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