| Organization Name: | SOUTHEASTERN FAMILY FOOT CARE, LLC |
| NPI Number: | 1033457106 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TROY D ZIMBELMAN (PRESIDENT) |
| Mailing Address: | 660 Mcqueen Smith Rd N Suite F Prattville |
| State: | AL US |
| Postal Code: | 360667554 |
| Phone Number: | 3343588666 |
| Fax Number: | 3343588667 |
| NPI Enumeration Date: | 01/24/2013 |
| NPI Last Update Date: | 01/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 182 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |