| Organization Name: | SEDALIA FOOT CLINIC PC |
| NPI Number: | 1174559579 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAULA A BROWN (OFFICE MANAGER) |
| Mailing Address: | 519 E 13th St Sedalia |
| State: | MO US |
| Postal Code: | 653015909 |
| Phone Number: | 6608265897 |
| Fax Number: | 6608264691 |
| NPI Enumeration Date: | 06/25/2006 |
| NPI Last Update Date: | 06/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 000587 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |