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General NPI Number Information
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NPI Number | 1366533432
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Entity Type | Organization
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Legal Business Name | FAMILY PODIATRY P.A.
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 209 N 6TH ST
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City | INDEPENDENCE
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State | KS
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Zip | 67301-3100
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Country | US
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Telephone | 620-331-1840
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Fax | 620-331-7530
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Provider Business Mailing Address
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Address Line | 209 N 6TH ST PO BOX 372
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City | INDEPENDENCE
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State | KS
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Zip | 67301-3100
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Country | US
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Telephone | 620-331-1840
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Fax | 620-331-7530
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Authorized Official
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Title or Position | OWNER
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Name | DR. BARRY E WESSELOWSKI
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Credential |
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Telephone | 620-331-1840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State | KS
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