Ilse Michelle Bogard, PT,DPT

Individual provider Active NPI Physical Therapist · Belding, MI

NPI 1770085557 · NPPES record last updated Mar 7, 2018

Key facts

NPI
1770085557
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5501016833 (MI)
Practice address
1320 W State St Ste 3D
Belding, MI 48809-9245
Phone
(616) 244-1110
NPI assigned
Mar 7, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5501016833MIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501016833 MI Yes

Addresses

Primary practice location

1320 W State St Ste 3D
Belding, MI 48809-9245

Mailing address

1320 W State St Ste 3D
Belding, MI 48809-9245
Phone (616) 244-1110

Other providers in Belding, MI

All providers in Belding, MI · Physical Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.