Organization Name: | THE FOOT CLINIC OF WEST LOUISIANA |
NPI Number: | 1215056635 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JIM HARVEY (OWNER) |
Mailing Address: | 395 S Capitol St Many |
State: | LA US |
Postal Code: | 714493049 |
Phone Number: | 3372391061 |
Fax Number: | 3372391062 |
NPI Enumeration Date: | 03/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |