| Organization Name: | FEET FIRST PODIATRY LLC |
| NPI Number: | 1336237163 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL ADAMOVSKY (PRESIDENT) |
| Mailing Address: | 650 West Taylor Street Specialty Clinic 2nd Floor Vandalia |
| State: | IL US |
| Postal Code: | 62471 |
| Phone Number: | 6364777300 |
| Fax Number: | 6369220884 |
| NPI Enumeration Date: | 10/10/2006 |
| NPI Last Update Date: | 03/24/2011 |
| 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: | |