Individual
DR. JUSTIN WADE FOGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
398 CHESSER ROAD, SUITE 2, CHELSEA, AL 35043
(205) 678-1000
(205) 678-1001
Mailing address
398 CHESSER ROAD, SUITE 2, CHELSEA, AL 35043
(205) 678-1000
(205) 678-1001
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2069
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51525708
BCBS PROVIDER
AL
Enumeration date
05/23/2007
Last updated
04/28/2010
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