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Individual

MR. BRENT FOSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1500 N SIOUX AVE, CLAREMORE, OK 74017-7401
(918) 923-4700
(918) 923-4701
Mailing address
1500 N. SIOUX AVE., SUITE 109, CLAREMORE, OK 74017
(918) 923-4700
(918) 923-4701

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
3812
OK
225100000X
Physical Therapist
3812
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200083390A
OK
05
200468590A
OK
Enumeration date
12/13/2005
Last updated
11/08/2024
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