Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 13573PT | AZ |
NPI | 1003318338 |
---|---|
Provider Name | Mikaila E Foster |
First Address | Washington, DC 20011-7027 |
Second Address | Washington, DC 20010-2921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2018 |
Last Update Date | 02/03/2018 |