Provider Demographics
NPI:1194033910
Name:BOGLIOLI, SARRE (DPT)
Entity Type:Individual
Prefix:DR
First Name:SARRE
Middle Name:
Last Name:BOGLIOLI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 NC HIGHWAY 801 N
Mailing Address - Street 2:
Mailing Address - City:BERMUDA RUN
Mailing Address - State:NC
Mailing Address - Zip Code:27006-7905
Mailing Address - Country:US
Mailing Address - Phone:336-998-1149
Mailing Address - Fax:
Practice Address - Street 1:329 NC HIGHWAY 801 N
Practice Address - Street 2:
Practice Address - City:BERMUDA RUN
Practice Address - State:NC
Practice Address - Zip Code:27006
Practice Address - Country:US
Practice Address - Phone:336-998-1149
Practice Address - Fax:336-998-1145
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01363200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist