Provider Demographics
NPI:1588745020
Name:BOGGS, AARON THOMAS (ATC)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:THOMAS
Last Name:BOGGS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3149 CHESTER AVE
Mailing Address - Street 2:FREEDOM HIGH SCHOOL
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-2866
Mailing Address - Country:US
Mailing Address - Phone:610-867-5843
Mailing Address - Fax:610-865-9015
Practice Address - Street 1:3149 CHESTER AVE
Practice Address - Street 2:FREEDOM HIGH SCHOOL
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-2866
Practice Address - Country:US
Practice Address - Phone:610-867-5843
Practice Address - Fax:610-865-9015
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001817A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer