Individual
MISS MELISSA BOGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, CSCS, NASM-PES
Contact information
Practice address
28088 W. NIAGARA STREET, LAKEMOOR, IL 60051
(708) 257-6774
Mailing address
28088 W. NIAGARA STREET, LAKEMOOR, IL 60051
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
96001558
IL
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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