Individual
DR. MICHAEL FOSSUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1830 S ALMA SCHOOL RD STE 116, MESA, AZ 85210-3086
(480) 222-5169
(480) 222-5163
Mailing address
1252 N SANTA ANNA ST, CHANDLER, AZ 85224-8592
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
7027
AZ
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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