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General NPI Number Information
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NPI Number | 1073708822
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Entity Type | Organization
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Legal Business Name | FOSTER CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 10/20/2009
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Provider Practice Location Address
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Address Line | 124 N PRAIRIE ST
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City | LIBERTY
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State | MO
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Zip | 64068-1644
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Country | US
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Telephone | 816-781-2700
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Fax | 816-781-2783
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Provider Business Mailing Address
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Address Line | 124 N PRAIRIE ST
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City | LIBERTY
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State | MO
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Zip | 64068-1644
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Country | US
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Telephone | 816-781-2700
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Fax | 816-781-2783
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL W. FOSTER
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Credential | D.C.
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Telephone | 816-781-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 002757
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License Number State | MO
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