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Individual

MRS. CONNIE SUE BOGGESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CTRS,OTR/L

Contact information

Practice address
2216 NEWMANS BRANCH ROAD, RURAL ROUTE 3 BOX 397, MILTON, WV 25541
(304) 634-1845
(304) 743-5267
Mailing address
PO BOX 102, 2216 NEWMANS BRANCH ROAD, MILTON, WV 25541-0102
(304) 634-1845
(304) 743-5267

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1239
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810006782
WV
Enumeration date
10/09/2005
Last updated
07/28/2014
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