Healthcare Provider Details

I. General information

NPI: 1568992824
Provider Name (Legal Business Name): FOSTERING WELLNESS SPRINGFIELD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 07/21/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

366 RIVER ST
SPRINGFIELD VT
05156-2242
US

IV. Provider business mailing address

366 RIVER ST
SPRINGFIELD VT
05156-2242
US

V. Phone/Fax

Practice location:
  • Phone: 802-886-2555
  • Fax: 802-886-2002
Mailing address:
  • Phone: 802-886-2555
  • Fax: 802-886-2002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateVT

VIII. Authorized Official

Name: DR. CHARLES FOSTER
Title or Position: MEMBER
Credential: DC
Phone: 802-886-2555