Organization
ABUNDANTLY FRUITFUL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LA VALLE FOSTER (CEO)
(626) 716-7390
Entity
Organization
Contact information
Practice address
1621 CENTRAL AVE STE 8525, CHEYENNE, WY 82001-4531
(626) 716-7390
Mailing address
1621 CENTRAL AVE STE 8525, CHEYENNE, WY 82001-4531
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2025
Last updated
04/24/2025
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