Individual
RICKIE MACKENZIE BOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
218 WASHINGTON AVE, PORTLAND, ME 04101-2632
(207) 773-5778
(207) 773-5773
Mailing address
218 WASHINGTON AVE, PORTLAND, ME 04101-2632
(207) 773-5778
(207) 773-5773
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MT3944
ME
Other
Enumeration date
06/23/2009
Last updated
06/23/2009
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