Individual
THOMAS FOGARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
216 S LEANDRO ST, ANAHEIM, CA 92807-3931
(714) 328-8030
Mailing address
216 S LEANDRO ST, ANAHEIM, CA 92807-3931
(714) 328-8030
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5434
CA
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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