Healthcare Provider Details

I. General information

NPI: 1568157386
Provider Name (Legal Business Name): CONTEMPORARY FOOT AND ANKLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 04/07/2023
Certification Date: 04/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S COOPER ST
JACKSON MI
49201-1598
US

IV. Provider business mailing address

100 S COOPER ST
JACKSON MI
49201-1598
US

V. Phone/Fax

Practice location:
  • Phone: 517-879-4241
  • Fax:
Mailing address:
  • Phone: 517-879-4241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN ZWECK
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential: DPM
Phone: 217-621-9890