Healthcare Provider Details

I. General information

NPI: 1851835268
Provider Name (Legal Business Name): FOOT HEALTH CENTER OF MERRIMACK VALLEY-WPHO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 ANDOVER ST SUITE 209
NORTH ANDOVER MA
01845-5044
US

IV. Provider business mailing address

451 ANDOVER ST SUITE 209
NORTH ANDOVER MA
01845-5044
US

V. Phone/Fax

Practice location:
  • Phone: 978-686-7623
  • Fax: 978-683-9911
Mailing address:
  • Phone: 978-686-7623
  • Fax: 978-683-9911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. TERESA BURTOFT
Title or Position: PRESIDENT
Credential: DPM
Phone: 978-423-9581