MEDICARE: MUHLENBERG FAMILY FOOTCARE LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	SC004207R	PA

General Provider Information

NPI Number	:	1598081259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUHLENBERG FAMILY FOOTCARE LTD

Provider Business Mailing Address
First Line	:	4148 KUTZTOWN RD
Second Line	:
City	:	TEMPLE
State	:	PA
Zip	:	19560-1900
Country	:	US
Telephone Number	:	610-375-0395
Fax Number	:	610-685-7849

Provider Business Practice Location Address
First Line	:	4148 KUTZTOWN RD
Second Line	:
City	:	TEMPLE
State	:	PA
Zip	:	19560-1900
Country	:	US
Telephone Number	:	610-375-0395
Fax Number	:	610-685-7849

Authorized Official
Title or Position	:	OWNER
Name	:	BRIAN SCOTT KLEE
Credential	:	DPM
Telephone Number	:	610-375-0395

Provider Enumeration Date	:	04/20/2010
Last Update Date	:	04/20/2010

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