Individual
JAIME L FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
715 S TAFT AVE, FREMONT, OH 43420-3200
(612) 940-3709
Mailing address
715 S TAFT AVE, FREMONT, OH 43420-3200
(612) 940-3709
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10023
MN
363AM0700X
Medical Physician Assistant
2933
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
751196500
—
MN
Enumeration date
05/10/2006
Last updated
10/07/2009
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