Provider Demographics
NPI:1902072747
Name:BOEHLE, BETHANY K (DC)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:K
Last Name:BOEHLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:K
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:22 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-8829
Mailing Address - Country:US
Mailing Address - Phone:413-374-5158
Mailing Address - Fax:413-213-0434
Practice Address - Street 1:22 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-8829
Practice Address - Country:US
Practice Address - Phone:413-374-5158
Practice Address - Fax:413-213-0434
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3185111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor