Organization Name: | ADVANCED FOOT CARE PC |
NPI Number: | 1467671867 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TIMOTHY FISHER (PRESIDENT) |
Mailing Address: | 1303 E Grand Ave Laramie |
State: | WY US |
Postal Code: | 820704137 |
Phone Number: | 3077210022 |
Fax Number: | |
NPI Enumeration Date: | 04/24/2007 |
NPI Last Update Date: | 12/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 113 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WY |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |