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1083019863
MICHELLE FOGG
LAKE OSWEGO, OR
NPI
1083019863
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 6204)
Enumeration Date
2014-10-23
Last Update Date
2014-10-23
Business Address
-- MICHELLE FOGG PT
4500 KRUSE WAY SUITE 310
LAKE OSWEGO, OR 97035
Phone number: 503-620-3407
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Mailing Address
-- MICHELLE FOGG PT
8546 SW 160TH AVE
BEAVERTON, OR 97007
Phone number: 503-330-8751
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