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Individual

LARRY FOSTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
9334 MEMORIAL, DETROIT, MI 48228
(313) 948-9142
Mailing address
9334 MEMORIAL, DETROIT, MI 48228
(313) 948-9142

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7657
MI
Enumeration date
07/29/2015
Last updated
07/29/2015
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