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Individual

MR. GREGORY W. FOGT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
120 W. MAIN ST., RUSSELLS POINT, OH 43348-0636
(937) 843-2048
(937) 843-2371
Mailing address
11659 N TOWNSHIP ROAD 88, LAKEVIEW, OH 43331-9379
(937) 843-5779

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03-1-10786
OH

Other

Enumeration date
03/01/2007
Last updated
07/08/2007
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