Healthcare Provider Details

I. General information

NPI: 1356267926
Provider Name (Legal Business Name): FOOT CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 STOCKYARD RD STE J1
MISSOULA MT
59808-1548
US

IV. Provider business mailing address

PO BOX 843465
LOS ANGELES CA
90084-3465
US

V. Phone/Fax

Practice location:
  • Phone: 406-543-5333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CRAIG J MCLAWS
Title or Position: OWNER
Credential:
Phone: 406-252-5444