Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers | |
Podiatrist |
213E00000X | 48 | Podiatry | |
Prosthetic/Orthotic Supplier |
335E00000X | 51 | Medical Supply Company with Orthotist |
| NPI Number | 1750609772 |
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| LBN Legal business name | NORTHLAND FOOT & ANKLE SPECIALISTS | ||||||||
| Authorized official | SARAH WHITTAKER - (CEO) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 05/14/2010 | ||||||||
| Last updated | 05/29/2015 - About 11 years ago | ||||||||
| Identifiers |
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