Individual
DR. MICA VONNE FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
508 WASHINGTON ST, THE DALLES, OR 97058-2232
(541) 993-7003
Mailing address
1012 CASCADE AVE, HOOD RIVER, OR 97031-1402
(541) 993-7003
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3612
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3612
OREGON LICENSE NUMBER
OR
Enumeration date
02/20/2007
Last updated
07/08/2007
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