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General NPI Number Information
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NPI Number | 1194756510
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Entity Type | Individual
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Provider Name | STONEY FOSTER D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 7149 W EMERALD ST
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City | BOISE
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State | ID
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Zip | 83704-8620
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Country | US
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Telephone | 702-376-4940
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Fax |
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Provider Business Mailing Address
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Address Line | 746 N LONGHORN AVE
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City | EAGLE
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State | ID
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Zip | 83616-4360
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Country | US
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Telephone | 208-949-6301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CHIA-1104
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License Number State | ID
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