Provider Demographics
NPI:1396901385
Name:BOGART, DEBORA LIMAURO (LMT)
Entity type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:LIMAURO
Last Name:BOGART
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:344 E. FINDLAY ST.
Mailing Address - City:VAUGHNSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45893-0037
Mailing Address - Country:US
Mailing Address - Phone:419-796-0058
Mailing Address - Fax:
Practice Address - Street 1:344 E. FINDLAY ST.
Practice Address - Street 2:
Practice Address - City:VAUGHNSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45893-0037
Practice Address - Country:US
Practice Address - Phone:419-796-0058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.016579172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist