Individual
MRS. JACQUELYN T. FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
720 WESTVIEW DR SW, ATLANTA, GA 30310-1458
(404) 616-1415
(404) 616-1417
Mailing address
1271 POUNDS LN, CLARKSTON, GA 30021-2830
(404) 616-1415
(404) 616-1417
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
001688
GA
Other
Enumeration date
11/02/2007
Last updated
11/02/2007
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