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Individual

TRENTON G BOGGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1114 W COOK RD, FORT WAYNE, IN 46825-3214
(260) 483-5588
Mailing address
11817 AUTUMN TREE DR, FORT WAYNE, IN 46845-1905
(260) 637-7181

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001740
IN

Other

Enumeration date
08/07/2006
Last updated
07/08/2007
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