Individual
MR. SHAD ALAN FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
10963 VAN WERT DECATUR RD, VAN WERT, OH 45891-9211
(419) 238-6686
(419) 238-6201
Mailing address
10963 VAN WERT DECATUR RD, VAN WERT, OH 45891-9211
(419) 238-6686
(419) 238-6201
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
08002137A
IN
111N00000X
Chiropractor
Primary
2440
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2527573
—
OH
01
—
9312811
PTAN
OH
01
—
H536770
GROUP PTAN
OH
01
—
H536771
INDIVIDUAL PTAN
OH
Enumeration date
08/31/2006
Last updated
05/11/2017
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