Individual
ERIC JONATHAN FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LOTR
Contact information
Practice address
312 CAPE BRETON DR, SLIDELL, LA 70458-8811
(985) 645-8978
Mailing address
258 EDNA RD, COLUMBIA, MS 39429-9221
(601) 337-1724
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1549
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT1549
STATE LICENSE NUMBER
MS
Enumeration date
02/17/2009
Last updated
02/17/2009
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