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General NPI Number Information
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NPI Number | 1417469552
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Entity Type | Organization
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Legal Business Name | FEET FIRST, PLLC
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 10/30/2017
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Provider Practice Location Address
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Address Line | 345 W BROAD ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-2331
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Country | US
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Telephone | 931-854-9222
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Fax | 931-954-9902
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Provider Business Mailing Address
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Address Line | 345 W BROAD ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-2331
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Country | US
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Telephone | 931-854-9222
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Fax | 931-954-9902
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Authorized Official
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Title or Position | OWNER
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Name | CAROLE ROSENBAUM
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Credential | DPM
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Telephone | 931-432-6497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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