| Organization Name: | THE FOOT CLINIC OF WEST LOUISIANA |
| NPI Number: | 1104957695 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DENISE HARVEY (MANAGER) |
| Mailing Address: | 901 Shirley Street Deridder |
| State: | LA US |
| Postal Code: | 70634 |
| Phone Number: | 3372391061 |
| Fax Number: | 3372391062 |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 08/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |