| Mark Bogert | |
|
5673 Airport Rd Roanoke VA 24012-1119 | |
| (540) 523-8080 | |
| (540) 562-8867 |
| Full Name | Mark Bogert |
|---|---|
| Speciality | Counselor |
| Location | 5673 Airport Rd, Roanoke, Virginia |
| Authorized Official Name and Position | Lisa M Mcdowell (DIRECTOR) |
| Authorized Official Contact | 5405238054 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Bogert 5673 Airport Rd Roanoke VA 24012-1119 Ph: (540) 523-8080 | Mark Bogert 5673 Airport Rd Roanoke VA 24012-1119 Ph: (540) 523-8080 |
| NPI Number | 1518342393 |
|---|---|
| Provider Enumeration Date | 07/22/2015 |
| Last Update Date | 11/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518342393 | NPI | - | NPPES |
| 601035424 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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