Organization
FOGARTY CHIROPRACTIC LIFE CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN GEORGE FOGARTY CHIROPRACTOR (OWNER/CHIROPRACTOR)
(321) 636-5200
Entity
Organization
Contact information
Practice address
839 BARTON BLVD, ROCKLEDGE, FL 32955-3127
(321) 636-5200
(321) 639-0418
Mailing address
839 BARTON BLVD, ROCKLEDGE, FL 32955-3127
(321) 636-5200
(321) 639-0418
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
11/10/2010
Last updated
08/11/2011
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