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Individual

RYAN SPENCER FOUGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
1300 ACADEMY RD # 921, CULVER, IN 46511-1234
(574) 842-8299
Mailing address
1300 ACADEMY RD # 921, CULVER, IN 46511-1234
(574) 842-8299

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001799A
IN

Other

Enumeration date
11/02/2011
Last updated
11/02/2011
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