Individual
ALEX FOGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
380 N ESTRELLA PKWY STE A1, GOODYEAR, AZ 85338-2885
(623) 322-0654
(623) 322-0664
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(866) 370-8206
(517) 435-3670
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05014613A
IN
225100000X
Physical Therapist
Primary
CP011725T
MD
225100000X
Physical Therapist
LPT-32055
AZ
225100000X
Physical Therapist
PT018257
OH
225100000X
Physical Therapist
PT210002132
DC
Other
Enumeration date
08/14/2019
Last updated
01/02/2023
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