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General NPI Number Information
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NPI Number | 1326730052
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Entity Type | Organization
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Legal Business Name | RIVER VALLEY TOTAL FOOT CARE LLC
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/29/2023
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Provider Practice Location Address
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Address Line | 312 END OF ROAD ST
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City | POTEAU
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State | OK
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Zip | 74953-5482
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Country | US
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Telephone | 918-649-5349
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Fax |
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Provider Business Mailing Address
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Address Line | 312 END OF ROAD ST
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City | POTEAU
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State | OK
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Zip | 74953-5482
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Country | US
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Telephone | 918-649-5349
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VALERIE ORSBURN
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Credential | RN
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Telephone | 918-649-5349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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