Provider Demographics
NPI:1164880076
Name:HOGUE, BEN (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:
Last Name:HOGUE
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 RON MCHENRY RD
Mailing Address - Street 2:
Mailing Address - City:KNOX
Mailing Address - State:PA
Mailing Address - Zip Code:16232-6145
Mailing Address - Country:US
Mailing Address - Phone:814-227-7930
Mailing Address - Fax:
Practice Address - Street 1:455 SCOTLAND RD
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16444-0001
Practice Address - Country:US
Practice Address - Phone:814-732-1860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARTO0002592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer