Provider Demographics
NPI:1487749503
Name:BOGGS CHIROPRACTIC LLC
Entity type:Organization
Organization Name:BOGGS CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BOGGS
Authorized Official - Suffix:
Authorized Official - Credentials:D,C
Authorized Official - Phone:330-896-2424
Mailing Address - Street 1:4212 TOWN XING BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7980
Mailing Address - Country:US
Mailing Address - Phone:330-896-2424
Mailing Address - Fax:330-896-3294
Practice Address - Street 1:4212 TOWN XING BLVD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7980
Practice Address - Country:US
Practice Address - Phone:330-896-2424
Practice Address - Fax:330-896-3294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty