Provider Demographics
NPI:1902825599
Name:FOSTER, DEANNA L (PT)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:L
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 FLINT RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6031
Mailing Address - Country:US
Mailing Address - Phone:256-340-9708
Mailing Address - Fax:256-340-9624
Practice Address - Street 1:1203 US HIGHWAY 98
Practice Address - Street 2:SUITE 1-C
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4277
Practice Address - Country:US
Practice Address - Phone:251-621-1021
Practice Address - Fax:251-621-7508
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1389225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-31298OtherBCBS
AL890014290Medicaid
AL1003819608OtherGROUP NPI
AL529917620Medicaid
AL1003819608OtherGROUP NPI
ALK531Medicare UPIN