Organization Name: | ADVANCED FOOT CARE S C |
NPI Number: | 1043358013 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN LEE WOLFINGTON (OWNER PODIATRIST) |
Mailing Address: | 1714 N 8th St Sheboygan |
State: | WI US |
Postal Code: | 530812734 |
Phone Number: | 9204576104 |
Fax Number: | 9204576105 |
NPI Enumeration Date: | 02/02/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 634 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |