Provider Demographics
NPI:1447449491
Name:FOSTER, ROBERT D (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:FOSTER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3585 RIVER EDGE VIEW CT NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-7220
Mailing Address - Country:US
Mailing Address - Phone:616-638-5871
Mailing Address - Fax:616-883-6074
Practice Address - Street 1:3585 RIVER EDGE VIEW CT NE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-7220
Practice Address - Country:US
Practice Address - Phone:616-638-5871
Practice Address - Fax:616-883-6074
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010351225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist