Kyle Fog is a student in an organized health care education training program in Walled Lake, MI. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Kyle Fog NPI is 1013364777. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
620 N PONTIAC TRL
WALLED LAKE, MI
ZIP 48390-448
Phone: (248) 669-2776
The enumeration date for this NPI number is 5/23/2016 and was last updated on 5/23/2016.