Gary Bohannon

NPI #1467430603 in Brainerd, Minnesota

Provider Information

NPI Number: 1467430603
Entity Type: Individual
Name: Gary Bohannon
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Enumeration Date: Jan 6, 2006
Last Updated: Jul 25, 2007

Practice Location

Address: 2024 S 6TH ST
City: Brainerd
State: Minnesota
ZIP Code: 56401-4529
Phone: (218) 825-7100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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