Individual
IVEN W BOEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
650 OAK AVE, NEOGA, IL 62447-1502
(217) 895-2222
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001655
IL
Other
Enumeration date
05/30/2006
Last updated
11/01/2024
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