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DR. JOHN J BOGANNAM DC
>> Chiropractor >> Chiropractic ProvidersRegistrant NPI Number: 1821106154
Individual Registrant:DR. JOHN J BOGANNAM DC
Gender: M
Not Sole Proprietor
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
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
Tel: 203-374-5560 Fax: 203-374-0736
Registration Information:
NPI: 1821106154
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractic Providers Chiropractor | CT | 000493 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
