Individual
AESOOK LEE BOGATKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9830 N 104TH DR, SUN CITY, AZ 85351-4704
(601) 717-3203
Mailing address
9830 N 104TH DR, SUN CITY, AZ 85351-4704
(601) 717-3203
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP050617
AZ
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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