Individual
AMANDA BOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2103 S MAIN ST, ELK CITY, OK 73644-9166
(580) 225-0075
Mailing address
440 MERCHANT DR, NORMAN, OK 73069-6470
(405) 809-8713
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3420
OK
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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