Provider Demographics
NPI:1831641349
Name:FOSTER, BRIDGET THERESE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:THERESE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 LAUREL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5364
Mailing Address - Country:US
Mailing Address - Phone:907-569-5663
Mailing Address - Fax:
Practice Address - Street 1:4325 LAUREL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5364
Practice Address - Country:US
Practice Address - Phone:907-569-5663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK110571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist