Individual
MR. CHARLES SCOTT VANDEBOGART JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2 FRONT ST, MILLBROOK, NY 12545-5948
(845) 677-5021
Mailing address
45 MEADOW RIDGE LN, LAGRANGEVILLE, NY 12540-5224
(845) 380-0504
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
NY
Other
Enumeration date
07/21/2017
Last updated
07/21/2017
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