Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI Number | 1962756270 |
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| LBN Legal business name | ADVANCED FOOT & ANKLE OF WISCONSIN LLC | ||||
| Authorized official | MICHAEL KOKAT - (D.P.M.) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 11/08/2012 | ||||
| Last updated | 10/04/2019 - About 7 years ago | ||||
| Identifiers |
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