Provider Demographics
NPI:1043526940
Name:FOSTER, REBECCA KARIN (PT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:KARIN
Last Name:FOSTER
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 1:11872 CAPITAL WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-6332
Mailing Address - Country:US
Mailing Address - Phone:502-261-1488
Mailing Address - Fax:502-261-1470
Practice Address - Street 1:11872 CAPITAL WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-6332
Practice Address - Country:US
Practice Address - Phone:502-261-1488
Practice Address - Fax:502-261-1470
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist