Individual
MR. MARK BOOHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
1628 OLD DONATION PKWY, VIRGINIA BEACH, VA 23454-3062
(757) 496-3092
(757) 496-2837
Mailing address
1716 FIVE FORKS RD, VIRGINIA BEACH, VA 23455-4324
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306000856
VA
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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