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General NPI Number Information
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NPI Number | 1780956649
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Entity Type | Organization
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Legal Business Name | FOSTER CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 02/07/2012
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 13000 FACTORY LN
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City | LOUISVILLE
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State | KY
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Zip | 40245-2004
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Country | US
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Telephone | 502-509-3121
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Fax |
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Provider Business Mailing Address
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Address Line | 13000 FACTORY LN
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City | LOUISVILLE
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State | KY
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Zip | 40245-2004
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Country | US
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Telephone | 502-509-3121
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASEY JORDAN FOSTER
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Credential | D.C.
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Telephone | 502-381-7048
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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 | 5220
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License Number State | KY
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