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General NPI Number Information
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NPI Number | 1104046325
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Entity Type | Organization
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Legal Business Name | NORTHWOOD FOOT AND ANKLE CENTER, PC
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 388 GARDEN AVE SUITE 120
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City | HOLLAND
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State | MI
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Zip | 49424-8998
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Country | US
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Telephone | 616-393-8886
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Fax | 616-393-9975
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Provider Business Mailing Address
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Address Line | 388 GARDEN AVE SUITE 120
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City | HOLLAND
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State | MI
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Zip | 49424-8999
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Country | US
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Telephone | 616-393-8886
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Fax | 616-393-9975
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICIA GUISINGER
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Credential | D.P.M.
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Telephone | 616-393-8886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 5901001739
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5901001739
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License Number State | MI
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