Individual
CHRISTINE LYNN BOHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
BOX 64 303 W MAIN ST, ADRIAN, MO 64720-9217
(816) 805-2980
Mailing address
303 W MAIN ST, PO BOX 64, ADRIAN, MO 64720-9217
(816) 805-2980
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
MO
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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