Bough, Mary Ann
Bough, Mary Ann is an sole proprietor health care provider with primary practice located at 3901 Hagan St Ste C , Bloomington IN 47401-8516. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Bough, Mary Ann can be contacted via phone (812) 336-7552.Contact Information
Primary practice address
3901 Hagan St Ste C
Bloomington IN 47401-8516
Phone: (812) 336-7552
Fax: (812) 336-7556
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 08001999A | Indiana |
Profile Details
| NPI number | 1467447516 |
|---|---|
| LBN Legal business name | Bough, Mary Ann |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 14th, 2005 |
| Last updated | Jan 30th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467447516 | NPPES |
| Indiana | MEDICAID | 200341440 |
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