Individual
MRS. JENILEE ROSE FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 517-3136
(434) 517-3626
Mailing address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592
(434) 517-3136
(434) 517-3626
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00110002882
VA
Other
Enumeration date
09/17/2008
Last updated
11/30/2011
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