Individual
MR. NICHOLAS LEE BOHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
621 SIX FLAGS DR, ARLINGTON, TX 76011-6305
(817) 385-8285
(817) 385-8261
Mailing address
2708 MARTIN DR, APT 3065, BEDFORD, TX 76021-5044
(316) 648-8525
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4733
TX
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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