Individual
TIFFANY LYN FONAGY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.T.C., P.E.S.
Contact information
Practice address
75 EVELYN DR, MILLERSBURG, PA 17061-1258
(717) 692-4708
(717) 692-5464
Mailing address
4175 MOUNTAIN VIEW RD APT 109, MECHANICSBURG, PA 17050-7628
(717) 732-1819
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RTO000015
PA
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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