| Doctor Name: | THERESE BOHUSCH |
| NPI Number: | 1932193927 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MPT |
| License Number: | PT 007673L |
| Business Practice Address: | 75 Mdos/sgopy Bldg 570 Hill Afb, UT - 84050 |
| Business Phone Number: | 8017775400 |
| Business Fax Number: | |
| Mailing Address: | 1100 S 2000 E, Apt #e233 CLEARFIELD |
| State: | UT |
| Postal Code: | 840151400 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/06/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | PT 007673L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |