Organization Name: | PIKEVILLE FOOT CARE CENTER PLLC |
NPI Number: | 1013972439 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRADWELL S. CHANEY (OWNER) |
Mailing Address: | 126 Trivette Drive Suite 101 Pikeville |
State: | KY US |
Postal Code: | 41501 |
Phone Number: | 6064320003 |
Fax Number: | 6064320076 |
NPI Enumeration Date: | 04/19/2006 |
NPI Last Update Date: | 02/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP1100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Podiatric |
Taxonomy Definition: |