| Doctor Name: | NATHAN WILBERT FOGARTY |
| NPI Number: | 1073874079 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | 82222312401 |
| Business Practice Address: | 2251 Connecticut Ave S Ste 3600 Sartell, MN - 563772556 |
| Business Phone Number: | 3205290036 |
| Business Fax Number: | 3202590038 |
| Mailing Address: | 201 5th Ave E Apt 206, SARTELL |
| State: | MN |
| Postal Code: | 563771261 |
| Phone Number: | 7017214229 |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2012 |
| NPI Last Update Date: | 06/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 82222312401 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |