Individual
ELIZABETH PLACE BOHORFOUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH4321
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
418961932
TRICARE
AL
01
—
51520641
BLUE CROSS
AL
01
—
6400002
UNITED HEALTHCARE
AL
Enumeration date
10/02/2006
Last updated
12/14/2011
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