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1841052313
BRIAN FOGELSTROM
VENICE, CA
NPI
1841052313
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-01-29
Last Update Date
2024-01-29
Business Address
BRIAN FOGELSTROM
503 OCEAN FRONT WALK
VENICE, CA 90291-2403
Phone number: 310-392-3070
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Mailing Address
BRIAN FOGELSTROM
503 OCEAN FRONT WALK
VENICE, CA 90291-2403
Phone number: 310-392-3070
Copy
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