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General NPI Number Information
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NPI Number | 1508880105
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Entity Type | Individual
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Provider Name | MICHAEL DAVID HOGUE MPT
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4492 FOOTHILLS DR
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City | LOVELAND
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State | CO
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Zip | 80537-3567
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Country | US
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Telephone | 970-391-2262
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Fax | 970-669-7262
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Provider Business Mailing Address
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Address Line | 2609 ARANCIA DR
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City | FORT COLLINS
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State | CO
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Zip | 80521-4921
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Country | US
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Telephone | 402-960-4020
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Fax | 970-669-7262
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9214
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License Number State | CO
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