Individual
RICHARD BOEHM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 E LANCASTER AVE, ARDMORE, PA 19003-2319
(610) 645-0546
Mailing address
17 E LANCASTER AVE, ARDMORE, PA 19003-2319
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
NJ D-1242
NJ
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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