Individual
MICHAEL BOGENREIF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L/ATC
Contact information
Practice address
3001 22ND ST. S., MOORHEAD, MN 56560
(701) 899-1108
Mailing address
3001 22ND ST. SOUTH, MOORHEAD, MN 56560
(701) 899-1108
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
30305
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
450226909
SANFORD HEALTH
ND
Enumeration date
04/04/2006
Last updated
08/23/2014
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