Individual
CAROLYN BOGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7300 WASHINGTON AVE STE B, MOUNT PLEASANT, WI 53406-6525
(262) 321-6000
Mailing address
7300 WASHINGTON AVE STE B, MOUNT PLEASANT, WI 53406-6525
(262) 321-6000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070024731
IL
225100000X
Physical Therapist
Primary
14602
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100198658
—
WI
Enumeration date
07/24/2019
Last updated
08/30/2022
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