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General NPI Number Information
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NPI Number | 1386709228
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Entity Type | Organization
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Legal Business Name | APACHE FOOT & ANKLE SPECIALIST LLC
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 05/13/2023
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Provider Practice Location Address
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Address Line | 2901 N TENAYA WAY STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89128-1404
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Country | US
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Telephone | 702-362-2622
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Fax | 702-362-0422
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Provider Business Mailing Address
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Address Line | 2901 N TENAYA WAY STE 200
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City | LAS VEGAS
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State | NV
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Zip | 89128-1404
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Country | US
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Telephone | 702-362-2622
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Fax | 702-362-0422
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEE AARON WITTENBERG
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Credential | DPM
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Telephone | 702-362-2622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0607
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License Number State | NV
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