Individual
LISA FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9562 19TH BAY ST APT A, NORFOLK, VA 23518-6211
(757) 754-1799
Mailing address
9562 19TH BAY ST APT A, NORFOLK, VA 23518-6211
(757) 754-1799
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
929525
VA
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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