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General NPI Number Information
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NPI Number | 1407284110
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Entity Type | Organization
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Legal Business Name | FOOTCARE & WELLNESS LLC
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 10/16/2013
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Provider Practice Location Address
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Address Line | 985 9TH AVE SW SUITE 405
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City | BESSEMER
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State | AL
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Zip | 35022
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Country | US
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Telephone | 205-481-8524
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Fax | 205-481-8820
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Provider Business Mailing Address
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Address Line | 985 9TH AVE SW SUITE 405
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City | BESSEMER
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State | AL
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Zip | 35022-4500
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Country | US
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Telephone | 205-481-8524
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Fax | 205-481-8820
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Authorized Official
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Title or Position | PODIATRIST
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Name | MARVIN E WILLIAMS
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Credential | DPM
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Telephone | 205-481-8524
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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 | 284
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License Number State | AL
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