Individual
MARK WILLIAM BOGERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
602 ASH AVE, GLEN ULLIN, ND 58632-0065
(701) 348-9175
Mailing address
4729 AMBERGLOW DR, BISMARCK, ND 58503-8846
(701) 426-7095
(701) 250-0182
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
ND 0534
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25559
BLUE CROSS/BLUE SHIELD
ND
05
—
54373
—
ND
Enumeration date
04/03/2008
Last updated
04/03/2008
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