Provider Demographics
NPI:1194965673
Name:FOSTER, LINDSEY L (PT)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:L
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 CIMARRON DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35769-4012
Mailing Address - Country:US
Mailing Address - Phone:205-876-4599
Mailing Address - Fax:
Practice Address - Street 1:1102 CIMARRON DR
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35769-4012
Practice Address - Country:US
Practice Address - Phone:205-876-4599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009568225100000X
ALPTH6333225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
582257510OtherTAX ID
GA421356739BMedicaid
GA421356739BMedicaid