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General NPI Number Information
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NPI Number | 1265603526
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Entity Type | Organization
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Legal Business Name | AMERICAN FOOT CARE CLINIC PLLC
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 518 E WHITEHOUSE CANYON RD STE 170
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-0544
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Country | US
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Telephone | 520-648-0444
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Fax | 520-648-6920
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Provider Business Mailing Address
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Address Line | 518 E WHITEHOUSE CANYON RD STE 170
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City | GREEN VALLEY
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State | AZ
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Zip | 85614-0544
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Country | US
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Telephone | 520-648-0444
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Fax | 520-648-6920
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ROBERT FRIDRICH
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Credential | DPM
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Telephone | 520-648-0444
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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 |
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License Number State |
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