Provider Demographics
NPI:1689935934
Name:NJOGHO, ANIM (DPT)
Entity Type:Individual
Prefix:
First Name:ANIM
Middle Name:
Last Name:NJOGHO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 LORRAIN DR APT 101
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0349
Mailing Address - Country:US
Mailing Address - Phone:240-429-1371
Mailing Address - Fax:
Practice Address - Street 1:2550 WINDSOR PL N
Practice Address - Street 2:
Practice Address - City:MANDAN
Practice Address - State:ND
Practice Address - Zip Code:58554-8151
Practice Address - Country:US
Practice Address - Phone:701-638-8106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 374U00000X
ND2444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No374U00000XNursing Service Related ProvidersHome Health Aide