Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3968-012 | WI |
NPI | 1003921073 |
---|---|
Provider Name | Dr. Amy L Foerster |
First Address | Salem, WI 53168-9037 |
Second Address | Kenosha, WI 53142-7308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 28/04/2012 |