Individual
DR. RICHARD BOHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
130 MIDDLEBROOK RD, WEST HARTFORD, CT 06119-1059
(860) 233-1033
(860) 233-0609
Mailing address
130 MIDDLEBROOK RD, WEST HARTFORD, CT 06119-1059
(860) 233-1033
(860) 233-0609
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003777
CT
Other
Enumeration date
09/07/2007
Last updated
09/07/2007
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