Healthcare Provider Details

I. General information

NPI: 1831477868
Provider Name (Legal Business Name): 1FOOT 2FOOT CENTRE FOR FOOT AND ANKLE CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5839 HARBOUR VIEW BLVD STE 101
SUFFOLK VA
23435-3797
US

IV. Provider business mailing address

PO BOX 848216
LOS ANGELES CA
90084-8216
US

V. Phone/Fax

Practice location:
  • Phone: 757-934-0768
  • Fax: 757-925-1901
Mailing address:
  • Phone: 757-384-6619
  • Fax: 224-220-9345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateVA

VIII. Authorized Official

Name: MATTHEW C DAIRMAN
Title or Position: OWNER
Credential:
Phone: 757-934-0768