Provider Demographics
NPI:1336944636
Name:FOSTER, SHAWN ELLIOTT (PT)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:ELLIOTT
Last Name:FOSTER
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 W SPRING ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-7102
Mailing Address - Country:US
Mailing Address - Phone:931-303-0446
Mailing Address - Fax:
Practice Address - Street 1:317 W SPRING ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-7102
Practice Address - Country:US
Practice Address - Phone:931-303-0446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist