Provider Information for 1033607650
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TIFFANY RENEE FOSTER
Sex: Female
NPI: 1033607650
Last Updated: 2018-05-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1033607650 | ||||||||||||
| Enumeration Date | 2018-04-30 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3409 W WENDOVER AVE STE I GREENSBORO, NC 27407-1579 United States Phone: 336-897-2375 | Fax: | ||||||||||||
| Primary Practice Address | 3409 W WENDOVER AVE STE I GREENSBORO, NC 27407 United States Phone: 336-897-2375 | Fax: | ||||||||||||
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