Individual
DR. TARA ELIZABETH FOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
3925 CHAIN BRIDGE RD STE 101, FAIRFAX, VA 22030-3938
(304) 830-2974
Mailing address
9920 FAIRFAX SQ APT 114, FAIRFAX, VA 22031-4220
(304) 830-2974
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
S04227
MD
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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