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General NPI Number Information
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NPI Number | 1548531791
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Entity Type | Individual
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Provider Name | KRISTOPHER W.R. FOULKE M.ED., ATC
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Gender | Male
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 182 W BRIDGE ST
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City | NEW HOPE
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State | PA
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Zip | 18938-1392
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Country | US
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Telephone | 215-862-2028
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Fax | 215-862-3198
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Provider Business Mailing Address
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Address Line | 136 E BRISTOL RD
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City | WARMINSTER
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State | PA
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Zip | 18974-2312
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Country | US
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Telephone | 215-206-8981
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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 | RT003828
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | J3-0000354
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License Number State | DE
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