Individual
MICHAEL JOSEPH BOEHKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
101 COLLEGE HILL DRIVE, BOX 2061, PHILIPPI, WV 26416
(304) 457-6300
Mailing address
BOX 2061, 101 COLLEGE HILL DRIVE, PHILIPPI, WV 26416
(304) 457-6300
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001094
WV
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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