Provider Demographics
NPI:1396531547
Name:FOGLER, CHRISTOPHE JAMES (LMT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHE
Middle Name:JAMES
Last Name:FOGLER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 SISKIYOU BLVD SPC 9
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-4400
Mailing Address - Country:US
Mailing Address - Phone:541-415-2407
Mailing Address - Fax:
Practice Address - Street 1:51 WATER ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1841
Practice Address - Country:US
Practice Address - Phone:541-488-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR28277225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist