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General NPI Number Information
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NPI Number | 1083780258
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Entity Type | Organization
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Legal Business Name | FAMILY FOOT CARE CENTER PC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 32 STATE ROAD EAST
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City | WESTMINSTER
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State | MA
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Zip | 01473
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Country | US
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Telephone | 978-874-1300
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Fax | 978-874-6244
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Provider Business Mailing Address
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Address Line | 32 STATE ROAD EAST
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City | WESTMINSTER
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State | MA
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Zip | 01473
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Country | US
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Telephone | 978-874-1300
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Fax | 978-874-6244
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAULA A FONTAINE
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Credential | DPM
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Telephone | 978-874-1300
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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 | 2063
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License Number State | MA
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