Provider Demographics
NPI:1841478559
Name:BOGGS, ASHLEY (LAK)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BOGGS
Suffix:
Gender:F
Credentials:LAK
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 74885
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44194-0968
Mailing Address - Country:US
Mailing Address - Phone:216-383-6776
Mailing Address - Fax:216-383-6745
Practice Address - Street 1:28080 CHARDON RD #204
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44092
Practice Address - Country:US
Practice Address - Phone:440-944-2863
Practice Address - Fax:440-944-2697
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0027352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer