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Individual

ANNE KATHERINE BOHLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
66 PAVILION AVE, PROVIDENCE, RI 02905-1522
(401) 461-9110
(401) 461-9194
Mailing address
66 PAVILION AVE, PROVIDENCE, RI 02905-1522
(401) 461-9110
(401) 461-9194

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
085.004229
IL
363AM0700X
Medical Physician Assistant
Primary
PA00854
RI

Other

Enumeration date
02/23/2012
Last updated
02/10/2017
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