Individual
JAMES ELLIS BOHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.B.S.
Contact information
Practice address
601 SW B AVE, LAWTON, OK 73501-3907
(580) 214-0244
Mailing address
6121 SW PARK PL, LAWTON, OK 73505-7731
(619) 341-2413
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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