Individual
ANNA BOGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T., M.M.P.
Contact information
Practice address
1395 JORDAN ST, NORTH LIBERTY, IA 52317-4759
(319) 774-3811
Mailing address
1016 130TH ST, WEST LIBERTY, IA 52776-9121
(563) 564-0720
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
006773
IA
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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