Provider Demographics
NPI:1154533263
Name:BOEHME, KARL A (DC)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:A
Last Name:BOEHME
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 3RD ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4235
Mailing Address - Country:US
Mailing Address - Phone:727-821-4500
Mailing Address - Fax:727-823-1300
Practice Address - Street 1:260 3RD ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4235
Practice Address - Country:US
Practice Address - Phone:727-821-4500
Practice Address - Fax:727-823-1300
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8316111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor