MEDICARE: DR. JENNIFER LYNN FOSTER DC

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	111N00000X	Chiropractor	CH8794	FL

General Provider Information

NPI Number	:	1063509396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER LYNN FOSTER DC

Provider Business Mailing Address
First Line	:	9200 BONITA BEACH RD SE STE 203
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34135-4278
Country	:	US
Telephone Number	:	239-390-0607
Fax Number	:	239-390-0601

Provider Business Practice Location Address
First Line	:	9200 BONITA BEACH RD SE STE 203
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34135-4278
Country	:	US
Telephone Number	:	239-390-0607
Fax Number	:	239-390-0601

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	01/31/2020

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