Healthcare Provider Details
I. General information
NPI: 1861541237
Provider Name (Legal Business Name): TOTALLY FEET INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/08/2007
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8753 YATES DR SUITE 110
WESTMINSTER CO
80031-6947
US
IV. Provider business mailing address
8753 YATES DR SUITE 110
WESTMINSTER CO
80031-6947
US
V. Phone/Fax
- Phone: 720-980-3668
- Fax: 303-934-5446
- Phone: 720-980-3668
- Fax: 303-934-5446
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 579 |
| License Number State | CO |
VIII. Authorized Official
Name: DR.
TERRY
LEROY
OEHLER
Title or Position: OWNER
Credential: D.P.M.
Phone: 720-980-3668