National Provider Identifier
Justin Henry Bogard, PT, DPT
Justin Henry Bogard, PT, DPT is listed in the NPPES registry with a primary specialty of Physical Therapist in East Aurora, NY and a listed phone number of (716) 714-7860.
Profile Overview
- NPI
- 1881200145
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- September 21, 2020
- Last Updated
- April 14, 2021
Practice Location
- 48 Douglas Ln
- East Aurora, NY 14052-2124
Phone: (716) 714-7860
Mailing Address
- Box 8000 Dept 314
- Buffalo, NY 14267-0002
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1881200145
- Entity Type
- Individual
- Last Name
- Bogard
- First Name
- Justin
- Middle Name
- Henry
- Credential
- PT, DPT
- Mailing Street Address
- Box 8000 Dept 314
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14267-0002
- Mailing Country
- US
- Mailing Phone
- (716) 213-0772
- Mailing Fax
- (716) 324-5004
- Practice Street Address
- 48 Douglas Ln
- Practice City
- East Aurora
- Practice State
- NY
- Practice ZIP Code
- 14052-2124
- Practice Country
- US
- Practice Phone
- (716) 714-7860
- Enumeration Date
- September 21, 2020
- Last Updated
- April 14, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- April 14, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)
- Other Identifiers
- 06289849 (NY)