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Individual

MARCUS A BOEHM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
2502 S ASHLAND AVE, GREEN BAY, WI 54304-5252
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14128-24
WI
225100000X
Physical Therapist
8594
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100083986
WI
Enumeration date
09/08/2017
Last updated
05/15/2025
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