Provider Demographics
NPI:1982820395
Name:FOGLER, NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:FOGLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ARDISIA CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4831
Mailing Address - Country:US
Mailing Address - Phone:609-620-0944
Mailing Address - Fax:
Practice Address - Street 1:23 ARDISIA CT
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4831
Practice Address - Country:US
Practice Address - Phone:609-620-0944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00610200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor