Provider Demographics
NPI:1639175151
Name:FOSTER, ANGELA (DC)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 328
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-0328
Mailing Address - Country:US
Mailing Address - Phone:573-348-5514
Mailing Address - Fax:
Practice Address - Street 1:4681 HIGHWAY 54
Practice Address - Street 2:STE 6
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065-2392
Practice Address - Country:US
Practice Address - Phone:573-348-5514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005022111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition