Healthcare Provider Details

I. General information

NPI: 1023266749
Provider Name (Legal Business Name): DAWN FOSTER, P.T., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2008
Last Update Date: 09/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7668 WIGMAKER CT
PLAINFIELD IN
46168-8906
US

IV. Provider business mailing address

7668 WIGMAKER CT
PLAINFIELD IN
46168-8906
US

V. Phone/Fax

Practice location:
  • Phone: 317-839-8055
  • Fax: 317-839-8055
Mailing address:
  • Phone: 317-839-8055
  • Fax: 317-839-8055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number53000105A
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAWN C FOSTER
Title or Position: OWNER
Credential: P.T.
Phone: 317-839-8055