MEDICARE: ALLYSON CLAWSON FOSTER AUD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	2201001982	VA

General Provider Information

NPI Number	:	1063268985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLYSON CLAWSON FOSTER AUD

Provider Business Mailing Address
First Line	:	2413 RENEWAL RD
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22902-6633
Country	:	US
Telephone Number	:	540-256-3456
Fax Number	:

Provider Business Practice Location Address
First Line	:	10200 THREE CHOPT RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-2083
Country	:	US
Telephone Number	:	804-288-3277
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2024
Last Update Date	:	06/25/2024

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