Individual
DALE ALFRED FOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2313 MCALEER RD, SEWICKLEY, PA 15143-8620
(412) 369-0448
Mailing address
2313 MCALEER RD, SEWICKLEY, PA 15143-8620
(412) 369-0448
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT001262A
PA
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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