Doctor Name: | ANNA BOGE |
NPI Number: | 1720462187 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.T., M.M.P. |
License Number: | 006773 |
Business Practice Address: | 1395 Jordan St North Liberty, IA - 523174759 |
Business Phone Number: | 3197743811 |
Business Fax Number: | |
Mailing Address: | 1016 130th St, WEST LIBERTY |
State: | IA |
Postal Code: | 527769121 |
Phone Number: | 5635640720 |
Fax Number: | |
NPI Enumeration Date: | 07/16/2015 |
NPI Last Update Date: | 07/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 006773 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |