Provider Demographics
NPI:1578327821
Name:JESSE J FOSTER DC, LLC
Entity Type:Organization
Organization Name:JESSE J FOSTER DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-344-3444
Mailing Address - Street 1:135 W DIMOND BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1907
Mailing Address - Country:US
Mailing Address - Phone:907-344-3444
Mailing Address - Fax:907-921-7670
Practice Address - Street 1:135 W DIMOND BLVD STE 104
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1907
Practice Address - Country:US
Practice Address - Phone:907-344-3444
Practice Address - Fax:907-921-7670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty