Individual
KENYON FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
305 HESTER CT, COLUMBIA, SC 29223-8507
(803) 707-4533
Mailing address
305 HESTER CT, COLUMBIA, SC 29223-8507
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
586
SC
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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