Kyle Fog
Kyle Fog is a Student in an Organized Health Care Education/Training Program in Walled Lake, Michigan. Practices as a sole proprietor. Licensed in Michigan.
- Licensed in
- MI
- In the registry since
- 2016
Practice location Address checks out
620 N Pontiac TrlWalled Lake, MI 48390-3448
Phone: (248) 669-2776
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X · Licence 5302041191 (MI) |
|---|
Record details
| NPI number | 1013364777 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | May 23, 2016 |
| Last updated in NPPES | May 23, 2016 |
| Mailing address | 620 N Pontiac Trl, Walled Lake, MI 48390-3448 |
Other providers in Walled Lake
-
Katelyn Khemmoro
2926 Montgomery Cir, Walled Lake, MI 48390-3605 · (248) 762-3297
-
Edmond Pierre Kirouac
2340 S Commerce Rd, Walled Lake, MI 48390-2174 · (248) 669-3434