Individual
MRS. MARTHA J FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 W NATIONAL RD, ENGLEWOOD, OH 45322-1469
(937) 836-3149
(937) 771-5422
Mailing address
2147 CORONETTE AVE, DAYTON, OH 45414-4537
(937) 331-8983
(937) 771-5422
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
03403
OH
Other
Enumeration date
10/15/2012
Last updated
10/15/2012
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