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Individual

DOMINIC BOGUCKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC, PA-C

Contact information

Practice address
170 W GERMANTOWN PIKE, NORRISTOWN, PA 19401-1389
(215) 605-3634
Mailing address
170 W GERMANTOWN PIKE, NORRISTOWN, PA 19401-1389

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
PA
363AS0400X
Surgical Physician Assistant
Primary
MA064456
PA

Other

Enumeration date
02/06/2017
Last updated
12/06/2023
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