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Individual
MR. SHAD ALAN FOSTER
Active
Individual
MR. SHAD ALAN FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
08002137A
IN
111N00000X
Chiropractor
Primary
2440
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2527573
—
OH
01
—
9312811
PTAN
OH
01
—
H536770
GROUP PTAN
OH
01
—
H536771
INDIVIDUAL PTAN
OH
Enumeration date
08/31/2006
Last updated
05/11/2017
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