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Individual
MR. ROGER FONG
Active
Individual
MR. ROGER FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
198001289
IL
225100000X
Physical Therapist
Primary
070013559
IL
Other
Enumeration date
07/03/2012
Last updated
10/30/2023
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