Individual
MARNITA FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
211 W MAIN ST, TISHOMINGO, OK 73460-1726
(580) 371-6212
Mailing address
PO BOX 77, RAVIA, OK 73455-0077
(580) 371-1904
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
173825
OK
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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