Provider Demographics
NPI:1861936098
Name:BOHN, RYAN (ATC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:BOHN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-2844
Mailing Address - Country:US
Mailing Address - Phone:716-373-1286
Mailing Address - Fax:
Practice Address - Street 1:521 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-2844
Practice Address - Country:US
Practice Address - Phone:716-373-1286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer