Individual
VONNIE BOGGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.A.T.
Contact information
Practice address
323 SW 1ST STREET, WINK, TX 79789-0908
(432) 940-5671
Mailing address
PO BOX 908, WINK, TX 79789-0908
(432) 940-5671
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0812
TX
Other
Enumeration date
02/15/2017
Last updated
02/15/2017
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