Provider Demographics
NPI:1801432026
Name:BOGART, NOELLE (ATC)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:BOGART
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23173-0009
Mailing Address - Country:US
Mailing Address - Phone:540-846-1003
Mailing Address - Fax:
Practice Address - Street 1:365 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23173-0009
Practice Address - Country:US
Practice Address - Phone:540-846-1003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-22
Last Update Date:2019-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer