Individual
MS. ALISA ANN FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 W DELAWARE AVE, NOWATA, OK 74048-2616
(918) 418-9594
Mailing address
615 W 6TH ST, COFFEYVILLE, KS 67337-4919
(620) 238-2289
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/04/2018
Last updated
06/16/2018
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