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1770520058
KENNETH BOGART
MISSOULA, MT
NPI
1770520058
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MT 28)
Enumeration Date
2006-06-02
Last Update Date
2007-07-08
Business Address
Mr. KENNETH BOGART PA
323 W ALDER ST
MISSOULA, MT 59802-4123
Phone number: 406-258-4191
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Mailing Address
Mr. KENNETH BOGART PA
323 W ALDER ST
MISSOULA, MT 59802-4123
Phone number: 406-258-4191
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