Individual
CHARLES BOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4656 WALFORD RD, APARTMENT 114, CLEVELAND, OH 44128-7153
(216) 804-6678
Mailing address
4656 WALFORD RD, APARTMENT 114, CLEVELAND, OH 44128-7153
(216) 804-6678
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN. 127610
OH
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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