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Individual
MRS. SHANA L BOGERT
Active
Individual
MRS. SHANA L BOGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007105
PA
Other
Enumeration date
03/17/2017
Last updated
11/27/2018
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