Individual
TIFFANY FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5413 W KINGSHIGHWAY, PARAGOULD, AR 72450-3368
(870) 215-4410
Mailing address
3102 CAMBRIDGE DR, PARAGOULD, AR 72450-5698
(870) 215-1409
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2319
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215444721
—
AR
Enumeration date
09/15/2016
Last updated
09/15/2016
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