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1003068453
DANIEL FOGERTY
BLOOMINGTON, IN
NPI
1003068453
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: IN 22004493A)
Enumeration Date
2008-10-16
Last Update Date
2008-10-16
Business Address
-- DANIEL FOGERTY SLP
725 N BELL TRACE CIR
BLOOMINGTON, IN 47408-4408
Phone number: 812-323-2858
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Mailing Address
-- DANIEL FOGERTY SLP
118 MEDICAL DR
CARMEL, IN 46032-2923
Phone number: 317-573-1037
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