Provider Demographics
NPI:1720302649
Name:FOSTER, JAMES ROGERS (PT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROGERS
Last Name:FOSTER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5416 E LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16511-1427
Mailing Address - Country:US
Mailing Address - Phone:814-899-8600
Mailing Address - Fax:814-898-1910
Practice Address - Street 1:5416 E LAKE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16511-1427
Practice Address - Country:US
Practice Address - Phone:814-899-8600
Practice Address - Fax:814-898-1910
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001655E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist