Provider Demographics
NPI:1164859294
Name:FOSTER, DANIEL III (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:FOSTER
Suffix:III
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 KENDRICK ST
Mailing Address - Street 2:B
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-4018
Mailing Address - Country:US
Mailing Address - Phone:720-343-6718
Mailing Address - Fax:
Practice Address - Street 1:11160 HURON ST
Practice Address - Street 2:#35
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-4377
Practice Address - Country:US
Practice Address - Phone:720-343-6718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT1689225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist