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General NPI Number Information
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NPI Number | 1194932566
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Entity Type | Organization
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Legal Business Name | A TO Z FAMILY FOOTCARE
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 12695 MCMANUS BLVD SUITE 1D
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City | NEWPORT NEWS
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State | VA
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Zip | 23602
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Country | US
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Telephone | 757-561-8671
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Fax | 757-873-1448
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Provider Business Mailing Address
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Address Line | 12695 MCMANUS BLVD SUITE 1D
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-4435
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Country | US
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Telephone | 757-561-8671
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Fax | 757-968-5445
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Authorized Official
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Title or Position | OWNER
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Name | AARON GLENN GOULD
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Credential | DPM
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Telephone | 757-561-8671
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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 | 0103300820
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License Number State | VA
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