Individual
KAYLEY FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Mailing address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4211
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
216997721
—
AR
01
—
5BW19
ARKANSAS BLUE CROSS BLUE SHIELD
AR
01
—
710857801
QUALCHOICE
AR
01
—
A002
TRICARE
AR
Enumeration date
08/30/2016
Last updated
12/29/2016
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