Individual
DANIEL FOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
2166 BLAIRS FERRY RD, HIAWATHA, IA 52233-7902
(319) 395-6000
Mailing address
3998 WESTDALE PKWY SW STE 300, CEDAR RAPIDS, IA 52404-9201
(319) 396-0222
(319) 395-6015
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
074065
IA
Other
Enumeration date
07/09/2006
Last updated
03/27/2025
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