Organization
FOSTER PRIMARY EYE CARE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY ALAN FOSTER O.D. (PRESIDENT)
(715) 284-4876
Entity
Organization
Contact information
Practice address
2 E MAIN ST, BLACK RIVER FALLS, WI 54615-1409
(715) 284-4876
(715) 284-4051
Mailing address
2 E MAIN ST, P.O. BOX 190, BLACK RIVER FALLS, WI 54615-1409
(715) 284-4876
(715) 284-4051
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1728-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38721100
—
WI
Enumeration date
01/23/2009
Last updated
11/18/2010
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