Provider Demographics
NPI:1811178759
Name:BEDOGNE, ANNA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIE
Last Name:BEDOGNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:MARIE
Other - Last Name:FLINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:505 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-3919
Mailing Address - Country:US
Mailing Address - Phone:906-399-7059
Mailing Address - Fax:
Practice Address - Street 1:618 55TH ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-3753
Practice Address - Country:US
Practice Address - Phone:262-657-8434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009354111N00000X
WI4453-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor