Organization Name: | AUTAUGA FAMILY FOOT CARE CLINIC |
NPI Number: | 1013187152 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TROY DAVID ZIMBELMAN (OWNER) |
Mailing Address: | 660 Mcqueen Smith Rd N Ste F Prattville |
State: | AL US |
Postal Code: | 360667559 |
Phone Number: | 3343588666 |
Fax Number: | 3343588667 |
NPI Enumeration Date: | 03/05/2008 |
NPI Last Update Date: | 05/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 182 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |