Provider Demographics
NPI:1821227448
Name:FOSTER, RYNE L (DPT)
Entity Type:Individual
Prefix:
First Name:RYNE
Middle Name:L
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9097 E DESERT COVE AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6710
Mailing Address - Country:US
Mailing Address - Phone:480-551-4961
Mailing Address - Fax:480-860-0356
Practice Address - Street 1:2122 E HIGHLAND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4739
Practice Address - Country:US
Practice Address - Phone:602-778-0900
Practice Address - Fax:602-778-6606
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2022-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ8521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ445308Medicaid
AZ445308Medicaid