Provider Demographics
NPI:1306438478
Name:FOSTER, JOLENE M (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JOLENE
Middle Name:M
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18367
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-0367
Mailing Address - Country:US
Mailing Address - Phone:859-359-6808
Mailing Address - Fax:
Practice Address - Street 1:3869 DEERTRAIL DR
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-3890
Practice Address - Country:US
Practice Address - Phone:484-866-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018136225100000X
KY006791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist