MEDICARE: WILLIAM ROBERT FOSTER

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	225200000X	Physical Therapy Assistant	9560	OR
2	225200000X	Physical Therapy Assistant	14274	CO

General Provider Information

NPI Number	:	1568963619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ROBERT FOSTER

Provider Business Mailing Address
First Line	:	2544 W 55TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-1644
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2544 W 55TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-1644
Country	:	US
Telephone Number	:	610-659-0623
Fax Number	:

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

Provider Enumeration Date	:	02/23/2018
Last Update Date	:	02/23/2018

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Directions to “ WILLIAM ROBERT FOSTER ” Practice Location

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