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General NPI Number Information
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NPI Number | 1003991647
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Entity Type | Organization
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Legal Business Name | WINONA FAMILY FOOT CARE, LTD
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 111 MARKET ST SUITE 3C
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City | WINONA
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State | MN
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Zip | 55987-5532
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Country | US
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Telephone | 507-452-0994
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Fax | 507-452-1072
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Provider Business Mailing Address
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Address Line | 111 MARKET ST SUITE 3C
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City | WINONA
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State | MN
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Zip | 55987-5532
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Country | US
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Telephone | 507-452-0994
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS R. NACHTIGAL
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Credential | DPM
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Telephone | 507-452-0994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 505
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License Number State | MN
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