Provider Demographics
NPI:1073670980
Name:HOGLE, CHARLENE A (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:A
Last Name:HOGLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CHAR
Other - Middle Name:
Other - Last Name:HOGLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:10431 E IRWIN CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-7723
Mailing Address - Country:US
Mailing Address - Phone:480-385-9710
Mailing Address - Fax:480-892-6690
Practice Address - Street 1:1902 E BASELINE RD
Practice Address - Street 2:STE 5
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6815
Practice Address - Country:US
Practice Address - Phone:480-545-7988
Practice Address - Fax:480-892-6690
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5284111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor