Provider Demographics
NPI:1740671445
Name:WOGALTER PT GROUP, INC
Entity type:Organization
Organization Name:WOGALTER PT GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOGALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-212-4638
Mailing Address - Street 1:19548 ESTUARY DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6201
Mailing Address - Country:US
Mailing Address - Phone:561-212-4638
Mailing Address - Fax:561-482-3599
Practice Address - Street 1:19548 ESTUARY DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6201
Practice Address - Country:US
Practice Address - Phone:561-212-4638
Practice Address - Fax:561-482-3599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy