Provider Demographics
NPI:1083865638
Name:FOOSE, BARBARA RAE (LMT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:RAE
Last Name:FOOSE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2434 PINE TREE RD
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17362-8337
Mailing Address - Country:US
Mailing Address - Phone:717-870-1583
Mailing Address - Fax:717-229-2768
Practice Address - Street 1:2434 PINE TREE RD
Practice Address - Street 2:
Practice Address - City:SPRING GROVE
Practice Address - State:PA
Practice Address - Zip Code:17362-8337
Practice Address - Country:US
Practice Address - Phone:717-870-1583
Practice Address - Fax:717-229-2768
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA32462174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist