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DR. JOHN J BOGANNAM DC

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1821106154

Individual Registrant:
DR. JOHN J BOGANNAM DC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
4154 MADISON AVENUE  TRUMBULL, CT 06611-3563 US
Tel: 203-374-5560  Fax: 203-374-0736

Contact information for business:
4154 MADISON AVENUE  TRUMBULL, CT 06611-3563 US
Tel: 203-374-5560  Fax: 203-374-0736

Registration Information:
NPI: 1821106154
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
Chiropractor
CT000493

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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