Individual
MR. KEITH A FOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS
Contact information
Practice address
530 SHADOWS LN, BATON ROUGE, LA 70806-6530
(225) 927-9185
(225) 231-3818
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5727
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06970
LA
2251X0800X
Orthopedic Physical Therapist
06970
LA
Other
Enumeration date
10/23/2006
Last updated
12/17/2020
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