Shannon Bohanek

NPI #1821709239 in Hayden, Idaho

Provider Information

NPI Number: 1821709239
Entity Type: Individual
Name: Shannon Bohanek
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: Dec 6, 2022
Last Updated: Dec 29, 2022

Practice Location

Address: 2151 W HAYDEN AVE
City: Hayden
State: Idaho
ZIP Code: 83835-7414
Phone: (208) 762-6772

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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