Provider Demographics
NPI:1871778258
Name:BOGAART FAMILY CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:BOGAART FAMILY CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:BOGAART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-479-6888
Mailing Address - Street 1:1645 STATE ROAD Z
Mailing Address - Street 2:
Mailing Address - City:PEVELY
Mailing Address - State:MO
Mailing Address - Zip Code:63070-2102
Mailing Address - Country:US
Mailing Address - Phone:636-479-6888
Mailing Address - Fax:636-479-6088
Practice Address - Street 1:1645 STATE ROAD Z
Practice Address - Street 2:
Practice Address - City:PEVELY
Practice Address - State:MO
Practice Address - Zip Code:63070-2102
Practice Address - Country:US
Practice Address - Phone:636-479-6888
Practice Address - Fax:636-479-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004020948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO235360OtherCARPENTERS
MO2233510OtherFIRST HEALTH
MO143663OtherUNITED
MO235360OtherGHP
MO682626OtherHEALTH LINK
MO2233510OtherFIRST HEALTH
MO682626OtherHEALTH LINK
MO=========BOGOtherMERCY
MO=========OtherCIGNA
MO=========OtherHUMANA
MO=========OtherAETNA
MO235360OtherGHP
MO143663OtherUNITED