Provider Demographics
NPI:1538949458
Name:BOHLING, CHARLES
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:BOHLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 UPPER TABORS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FORT GAY
Mailing Address - State:WV
Mailing Address - Zip Code:25514
Mailing Address - Country:US
Mailing Address - Phone:210-379-9553
Mailing Address - Fax:
Practice Address - Street 1:395 UPPER TABORS CREEK RD
Practice Address - Street 2:
Practice Address - City:FORT GAY
Practice Address - State:WV
Practice Address - Zip Code:25514
Practice Address - Country:US
Practice Address - Phone:210-379-9553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker