Organization
MJBOMAN, LLC
Active
Other names
The Bridge Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BOMAN PT, DPT (OWNER/MEMBER)
(727) 954-0125
Entity
Organization
Contact information
Practice address
1807 SE 8TH AVE, CAPE CORAL, FL 33990-2399
(727) 954-0125
Mailing address
1807 SE 8TH AVE, CAPE CORAL, FL 33990-2399
(727) 954-0125
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
05/08/2024
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