Provider Demographics
NPI:1093500852
Name:BOGACZ, BROOKE SHARON (DC)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:SHARON
Last Name:BOGACZ
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 STANLEY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-5149
Mailing Address - Country:US
Mailing Address - Phone:978-602-0038
Mailing Address - Fax:
Practice Address - Street 1:637 STATE RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-2819
Practice Address - Country:US
Practice Address - Phone:508-679-5500
Practice Address - Fax:508-679-6199
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor