Organization Name: | SIWICKI & RICCIARDI PL |
NPI Number: | 1295197093 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICCIARDI A RICCIARDI (OWNER) |
Mailing Address: | 849 S Three Notch St Andalusia |
State: | AL US |
Postal Code: | 364205325 |
Phone Number: | 8506826522 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2016 |
NPI Last Update Date: | 03/22/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |