Individual
ANGELO JOSEPH BOLOGNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
282 NE 223RD AVE, GRESHAM, OR 97030-8555
(503) 912-1192
(503) 912-1275
Mailing address
1200 CORPORATE DR STE 400, BIRMINGHAM, AL 35242-5424
(423) 682-8840
(423) 602-2028
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11781
TN
225100000X
Physical Therapist
Primary
63365
OR
Other
Enumeration date
09/04/2018
Last updated
08/08/2019
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