| Organization Name: | FLEETWOOD FOOTCARE CENTER, PC |
| NPI Number: | 1598776833 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLAYTON R SMITH (OWNER) |
| Mailing Address: | 12 Lenhart Rd Fleetwood |
| State: | PA US |
| Postal Code: | 195228613 |
| Phone Number: | 6109446537 |
| Fax Number: | 6109448152 |
| NPI Enumeration Date: | 08/11/2006 |
| NPI Last Update Date: | 12/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 05/05/2008 |
| NPI Reactivation Date: | 06/04/2008 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |