Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry |
| NPI # | 1861906372 |
| LBN Legal business name | FOOT CLINIC, LLC |
| Authorized official | ALI DAVIS - (PHYSICIAN) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/20/2017 |
| Last updated | 01/10/2018 - About 8 years ago |
| Identifiers | n/a |
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FOOT CLINIC, LLC
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