Provider Demographics
NPI:1205129061
Name:FOGG, APRIL CHRISTINE (PT)
Entity type:Individual
Prefix:MS
First Name:APRIL
Middle Name:CHRISTINE
Last Name:FOGG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 COLLINGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-2401
Mailing Address - Country:US
Mailing Address - Phone:443-386-5181
Mailing Address - Fax:
Practice Address - Street 1:11 COLLINGWOOD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:MD
Practice Address - Zip Code:21131-2401
Practice Address - Country:US
Practice Address - Phone:443-386-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18659225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist