| Organization Name: | TAWAS FOOT CLINIC P.C. |
| NPI Number: | 1528094489 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RYAN R WRIGHT (BUSINESS MANAGER) |
| Mailing Address: | 166 M 55 Tawas City |
| State: | MI US |
| Postal Code: | 48763 |
| Phone Number: | 9893626558 |
| Fax Number: | 9893627168 |
| NPI Enumeration Date: | 06/23/2006 |
| NPI Last Update Date: | 02/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | 5901001133 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |