Healthcare Provider Details

I. General information

NPI: 1689860538
Provider Name (Legal Business Name): FOR FEET SAKE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 11/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11143 WINCHESTER PARK DR
NEW ORLEANS LA
70128-2717
US

IV. Provider business mailing address

11143 WINCHESTER PARK DR
NEW ORLEANS LA
70128-2717
US

V. Phone/Fax

Practice location:
  • Phone: 504-822-1122
  • Fax: 504-822-1177
Mailing address:
  • Phone: 504-822-1122
  • Fax: 504-822-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License NumberPD322R
License Number StateLA

VIII. Authorized Official

Name: DR. EUNICE V. HODGES
Title or Position: OWNER/MANAGER
Credential: DPM
Phone: 504-822-1155