NPI 1912135534

Rickie Mackenzie Bogle, LMT

Practitioner Contractor Portland, ME

Practice location

Address: 218 Washington Ave, Portland, ME 04101-2632
Phone: (207) 773-5778
Fax: (207) 773-5773

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence MT3944 (ME)

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Registry record

NPI: 1912135534
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Jun 2009
Record last updated: 23 Jun 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.