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General NPI Number Information
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NPI Number | 1164713509
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Entity Type | Organization
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Legal Business Name | GREENVILLE FOOT & ANKLE CENTER, LLC
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | N1697 MUNICIPAL DR SUITE 3
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City | GREENVILLE
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State | WI
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Zip | 54942-7700
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Country | US
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Telephone | 920-750-7900
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Fax |
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Provider Business Mailing Address
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Address Line | N1697 MUNICIPAL DR SUITE 3
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City | GREENVILLE
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State | WI
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Zip | 54942-7700
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PODIATRIST
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Name | DR. JULIE ABBOUD
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Credential | D.P.M.
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Telephone | 920-750-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 984025
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License Number State | WI
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