Provider Demographics
NPI:1104498823
Name:BOEHM, CAMIL (OTD, OTR)
Entity type:Individual
Prefix:
First Name:CAMIL
Middle Name:
Last Name:BOEHM
Suffix:
Gender:M
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2885 AMES ST
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80214-8519
Mailing Address - Country:US
Mailing Address - Phone:970-290-1828
Mailing Address - Fax:
Practice Address - Street 1:2885 AMES ST
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80214-8519
Practice Address - Country:US
Practice Address - Phone:970-290-1828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics