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General NPI Number Information
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NPI Number | 1275729907
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Entity Type | Organization
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Legal Business Name | PREMIER FOOT & ANKLE CENTER, PC
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Dates
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Enumeration Date | 09/17/2007
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Last Update Date | 01/23/2014
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Provider Practice Location Address
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Address Line | 7481 RIGHT FLANK RD SUITE 110
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-3838
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Country | US
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Telephone | 804-746-9797
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Fax | 804-746-9794
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Provider Business Mailing Address
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Address Line | 7481 RIGHT FLANK RD SUITE 110
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-3838
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Country | US
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Telephone | 804-746-9797
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Fax | 804-746-9794
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. DARLENE FOOTE WHEELER
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Credential |
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Telephone | 804-746-9797
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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 | 0103300807
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License Number State | VA
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