| Organization Name: | NORTHWOODS FOOT & ANKLE LLC |
| NPI Number: | 1326322884 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREA S DIRKSEN (OWNER/PODIATRIST) |
| Mailing Address: | 1400 Us Highway 51 N Unit G Arbor Vitae |
| State: | WI US |
| Postal Code: | 545689504 |
| Phone Number: | 7153583668 |
| Fax Number: | 7153180800 |
| NPI Enumeration Date: | 10/03/2011 |
| NPI Last Update Date: | 02/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 98025 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |