Provider Demographics
NPI:1841998093
Name:FOSTER, RACHEL E (LMT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LMT
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 132
Mailing Address - Street 2:
Mailing Address - City:MIDDLE GRANVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12849-0132
Mailing Address - Country:US
Mailing Address - Phone:518-409-2351
Mailing Address - Fax:
Practice Address - Street 1:2 RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:MIDDLE GRANVILLE
Practice Address - State:NY
Practice Address - Zip Code:12849
Practice Address - Country:US
Practice Address - Phone:518-409-2351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027018225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty