Provider Demographics
NPI:1003879750
Name:RAGLE, ROSEMARY BONNER (MS, ATC)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:BONNER
Last Name:RAGLE
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2095 HILLSIDE RD
Mailing Address - Street 2:PO BOX U-78
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06269-3078
Mailing Address - Country:US
Mailing Address - Phone:860-486-4641
Mailing Address - Fax:
Practice Address - Street 1:115 WEST RD
Practice Address - Street 2:2303
Practice Address - City:ELLINGTON
Practice Address - State:CT
Practice Address - Zip Code:06029-3775
Practice Address - Country:US
Practice Address - Phone:860-871-2079
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer