Provider Demographics
NPI:1033290036
Name:FOTI, DAVID JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:FOTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11717 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-2131
Mailing Address - Country:US
Mailing Address - Phone:414-259-9008
Mailing Address - Fax:414-259-9828
Practice Address - Street 1:11717 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-2131
Practice Address - Country:US
Practice Address - Phone:414-259-9008
Practice Address - Fax:414-259-9828
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1394111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor