Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 32130 | CA |
Y | 111NS0005X | Chiropractic Sports Physician | CH 60485899 | WA |
NPI | 1295020725 |
---|---|
Provider Name | Dr. Michael Bohrnsen |
First Address | Spokane Valley, WA 99037-8861 |
Second Address | Spokane Valley, WA 99037-8861 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2011 |
Last Update Date | 02/01/2015 |