Individual
HALEY FOGT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
329 DOERING ST, SIDNEY, OH 45365-1403
(937) 638-2973
Mailing address
329 DOERING ST, SIDNEY, OH 45365-1403
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
132680
OH
Other
Enumeration date
04/22/2014
Last updated
04/25/2014
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