Individual
MR. JACK L FOGELSONGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1316 BATTLEFIELD BLVD N, CHESAPEAKE, VA 23320-4517
(757) 548-4217
Mailing address
909 SHOAL CREEK TRL, CHESAPEAKE, VA 23320-9414
(757) 410-7775
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202001613
VA
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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