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Individual

SHAWN RAYMOND FOSTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
210 SIMMONS ST, MARYVILLE, TN 37801-4750
(865) 970-9800
(865) 374-7101
Mailing address
2010 SIMMONS STREET, MARYVILLE, TN 37801-0000
(865) 970-9800
(865) 374-7101

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
76536
TN

Other

Enumeration date
12/06/2010
Last updated
12/06/2010
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