Individual
NATHAN WILBERT FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2251 CONNECTICUT AVE S STE 3600, SARTELL, MN 56377-2556
(320) 529-0036
(320) 259-0038
Mailing address
201 5TH AVE E APT 206, SARTELL, MN 56377-1261
(701) 721-4229
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
82222312401
UT
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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