Provider Demographics
NPI:1619380300
Name:VOGLER, JOSEPH HAROLD (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:HAROLD
Last Name:VOGLER
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 1:165 DRAKE LN
Mailing Address - Street 2:
Mailing Address - City:LEDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07852-9673
Mailing Address - Country:US
Mailing Address - Phone:973-229-7086
Mailing Address - Fax:
Practice Address - Street 1:806 N 6TH ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:IL
Practice Address - Zip Code:62441-1226
Practice Address - Country:US
Practice Address - Phone:973-229-7086
Practice Address - Fax:217-826-5511
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2015-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36002257A2255A2300X
IL0960037832255A2300X
NJ25MT002128002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer