Healthcare Provider Details

I. General information

NPI: 1548921265
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: 01/05/2022
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 PLEASURE HOUSE RD STE 101
VIRGINIA BEACH VA
23455-4053
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: 757-934-0768
  • 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 State

VIII. Authorized Official

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