Individual
ERIC PATRICK MOGCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
82 PENNSYLVANIA AVE, AVONDALE, PA 19311-1140
(610) 268-5333
(610) 268-5331
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT015895
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M01424171
BCBS
PA
01
—
P01480137
RR MEDICARE
PA
Enumeration date
09/20/2005
Last updated
08/14/2015
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