Bogucke, Jacqueline Ann

Bogucke, Jacqueline Ann is an sole proprietor health care provider with primary practice located at 2300 State Road 44 , Oshkosh WI 54904-9137. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Bogucke, Jacqueline Ann can be contacted via phone (920) 233-2373.

Contact Information

Primary practice address
2300 State Road 44 Oshkosh WI 54904-9137
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 4368-024 Wisconsin

Profile Details

NPI number 1639233034
LBN Legal business name Bogucke, Jacqueline Ann
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 20th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639233034 NPPES
Wisconsin Other 4368-024 WI DEPARTMENT OF REG.

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