MR. Tommy Bohannan

NPI #1407213796 in Dunlap, Illinois

Provider Information

NPI Number
1407213796
Entity Type
Individual
Name
MR. Tommy Bohannan
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Durable Medical Equipment & Medical Supplies
Enumeration Date
Jan 19, 2016
Last Updated
Mar 8, 2016

Practice Location

Address
11417 N BOULDER CREEK CT
City
Dunlap
ZIP Code
61525-1500
Phone
(309) 678-8081

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies

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