Most Relevant Information
Provider Data
| NPI Number: | 1003068453 |
| Provider Name: | DANIEL FOGERTY SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 22004493A |
Most Important Dates
| Enumeration Date: | 10/16/2008 |
| Last Updated: | 10/16/2008 |
Provider Practice Location
725 N BELL TRACE CIR
BLOOMINGTON
IN
474084408
Practice Location Phone/Fax
| Phone: | 8123232858 |
| Fax: |
Provider Mailing Location
118 MEDICAL DR
CARMEL
IN
460322923
Provider Mailing Phone/Fax
| Phone: | 3175731037 |
| Fax: |