Healthcare Provider Details

I. General information

NPI: 1598626780
Provider Name (Legal Business Name): TOE UP FOOT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3970 TARNRILL RD
DOUGLASVILLE GA
30135-2591
US

IV. Provider business mailing address

3970 TARNRILL RD
DOUGLASVILLE GA
30135-2591
US

V. Phone/Fax

Practice location:
  • Phone: 678-477-6952
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHANICE FIGUEROA
Title or Position: OWNER
Credential: NP
Phone: 678-477-6952