Provider Demographics
NPI:1972769628
Name:HOGAN, VALERIE JANE WILLIAMS (PT, PHD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:JANE WILLIAMS
Last Name:HOGAN
Suffix:
Gender:F
Credentials:PT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 WALTON WAY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-3826
Mailing Address - Country:US
Mailing Address - Phone:706-834-9244
Mailing Address - Fax:
Practice Address - Street 1:550 SILVER BLUFF RD STE 600
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-6038
Practice Address - Country:US
Practice Address - Phone:803-220-3655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019384225100000X
SC93742251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist