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General NPI Number Information
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NPI Number | 1346057841
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Entity Type | Organization
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Legal Business Name | 1FOOT 2FOOT CENTRE FOR FOOT AND ANKLE CARE, PC
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 109 WIMBLEDON SQ STE F
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4945
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Country | US
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Telephone | 757-698-4177
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Fax | 757-698-4176
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Provider Business Mailing Address
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Address Line | 1660 FEEHANVILLE DR STE 450
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-6023
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Country | US
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Telephone | 847-390-7666
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Fax | 224-220-9345
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW C DAIRMAN
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Credential | DPM
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Telephone | 757-934-0768
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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