| Organization Name: | SPENCER FOOT AND ANKLE CLINIC INC |
| NPI Number: | 1366649204 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICHARD BRUCE SPENCER (PRESIDENT) |
| Mailing Address: | 417 S East St Corydon |
| State: | IA US |
| Postal Code: | 500601860 |
| Phone Number: | 6418722462 |
| Fax Number: | 6413422292 |
| NPI Enumeration Date: | 07/02/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 00413 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |