Healthcare Provider Details

I. General information

NPI: 1700867850
Provider Name (Legal Business Name): JOSEPH PAUL FOSTER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28150 N MAIN ST STE A
DAPHNE AL
36526
US

IV. Provider business mailing address

28150 N MAIN ST STE A
DAPHNE AL
36526
US

V. Phone/Fax

Practice location:
  • Phone: 251-621-9010
  • Fax: 251-621-9011
Mailing address:
  • Phone: 251-621-9010
  • Fax: 251-621-9011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1491
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: