Individual
STEPHEN CHASE FOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
402 OAKRIDGE CMNS, SOUTH SALEM, NY 10590-2438
(203) 536-1081
(203) 966-6002
Mailing address
402 OAKRIDGE CMNS, SOUTH SALEM, NY 10590-2438
(203) 536-1081
(203) 966-6002
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
007145
NY
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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