Individual
MIKE FORNECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3935 SUNNYSIDE DR, ROCKINGHAM, VA 22801-2328
(540) 568-8200
Mailing address
3935 SUNNYSIDE DR, ROCKINGHAM, VA 22801-2328
(540) 568-8200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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