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
Fax: (812) 336-7556
Website:

Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467447516 NPPES
Indiana MEDICAID 200341440

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