Provider Demographics
NPI:1215620380
Name:BOOHER HEALTH LLC
Entity type:Organization
Organization Name:BOOHER HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGEOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-467-6707
Mailing Address - Street 1:3512 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-3728
Mailing Address - Country:US
Mailing Address - Phone:217-617-5652
Mailing Address - Fax:
Practice Address - Street 1:2724 SOUTHFIELD DR
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-6530
Practice Address - Country:US
Practice Address - Phone:217-617-5652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty