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General NPI Number Information
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NPI Number | 1255117362
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Entity Type | Individual
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Provider Name | ALEXIS FOSMER
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Gender | Female
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 1600 CAMPUS CT
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City | ABILENE
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State | TX
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Zip | 79601-3761
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Country | US
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Telephone | 325-674-2230
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Fax |
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Provider Business Mailing Address
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Address Line | 902 PALM ST
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City | ABILENE
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State | TX
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Zip | 79602-2443
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Country | US
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Telephone | 248-672-9597
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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