Provider Demographics
NPI:1598114902
Name:FOREMAN, KERI (MS, LAT ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:MS, LAT ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CAMPUS CIR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-7803
Mailing Address - Country:US
Mailing Address - Phone:443-352-4269
Mailing Address - Fax:443-352-4265
Practice Address - Street 1:100 CAMPUS CIR
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-7803
Practice Address - Country:US
Practice Address - Phone:443-352-4269
Practice Address - Fax:443-352-4265
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00005252255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer