Individual
MR. BRUCE WILLIAM BOEHM JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 N IOWA ST, KNOXVILLE, IA 50138-2833
(641) 842-4618
Mailing address
PO BOX 287, KNOXVILLE, IA 50138-0287
(641) 842-4618
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
630299
IA
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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