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Individual

DAVID C BOHARSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA, FNP

Contact information

Practice address
1411 9TH ST S, GREAT FALLS, MT 59405-4503
(406) 454-2171
Mailing address
PO BOX 8654, KALISPELL, MT 59904-1654
(406) 270-6240

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN24307
MT
367500000X
Certified Registered Nurse Anesthetist
Primary
24307
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4305318
MT
Enumeration date
05/27/2005
Last updated
12/23/2009
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