Individual
BRENTLY SHANE HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1123 FORSYTHE AVE, MONROE, LA 71201-4307
(318) 322-9980
(318) 322-9946
Mailing address
1123 FORSYTHE AVE, MONROE, LA 71201-4307
(318) 322-9980
(318) 322-9946
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06610
LA
Other
Enumeration date
07/22/2006
Last updated
07/08/2007
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