Individual
SHAYLA DIANE FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
2000 S MILLENIUM WAY, MERIDIAN, ID 83642-1551
(303) 319-3004
Mailing address
7529 W MIDDLE FORK ST, BOISE, ID 83709-6090
(303) 319-3004
Taxonomy
Speciality
Code
Description
License number
State
2083S0010X
Sports Medicine (Preventive Medicine) Physician
Primary
AT-588
ID
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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