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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ANNA FOGG, MSPT

Deactivated Sole Proprietor

ANNA FOGG, MSPT is a Specialist healthcare provider located in BLOOMSBURG, Pennsylvania. NPI 1174553408 is deactivated in the NPPES registry. Verify at CMS.

Specialist · BLOOMSBURG, PA

This NPI has been deactivated. The record was deactivated on October 11, 2016. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1174553408
Provider Type
Individual
Gender
Female
NPI Issued
Jul 3, 2006 (10.27397260274 yrs)
Last Updated
Mar 25, 2021
Deactivated
Oct 11, 2016
License
PT016699L (PA)
Sole Proprietor
Yes

Practice Information

Address
303 FISHER RUN RD
BLOOMSBURG, PA, 178157435
Browse PA providers · Browse ZIP 17815
Phone
5703325280
Fax
5703325280
Primary Specialty
Specialist
174400000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.