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General NPI Number Information
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NPI Number | 1366999252
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Entity Type | Organization
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Legal Business Name | SAVING SOLES PODIATRY LLC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 900 HIGHWAY 466
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City | LADY LAKE
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State | FL
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Zip | 32159-3926
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Country | US
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Telephone | 352-255-3302
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 490552
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City | LEESBURG
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State | FL
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Zip | 34749-0552
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Country | US
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Telephone | 352-255-3302
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Fax | 352-354-9920
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. DAVID JASON HANCOCK
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Credential | DPM
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Telephone | 352-255-3302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | PO3579
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License Number State | FL
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