IndividualActive
Tommy Bohannan
NPI 1407213796 · Durable Medical Equipment & Medical Supplies · Dunlap, IL
Provider details
- NPI number
- 1407213796
- Entity type
- Individual
- Primary specialty
- Durable Medical Equipment & Medical SuppliesSuppliers
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Suppliers
Practice location
11417 N Boulder Creek Ct
Dunlap, IL 61525-1500
Phone: (309) 678-8081
Approximate (ZIP-level) locationGet directions
Mailing address
11417 N Boulder Creek Ct
Dunlap, IL 61525-1500
Registry dates
- Enumerated
- 2016-01-19
- Last updated
- 2016-03-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.