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General NPI Number Information
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NPI Number | 1417653312
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Entity Type | Organization
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Legal Business Name | BIG DOG SOLUTIONS LLC
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 3917 WEST RD STE 135
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City | LOS ALAMOS
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State | NM
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Zip | 87544-1776
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Country | US
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Telephone | 505-500-4301
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Fax |
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Provider Business Mailing Address
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Address Line | 51 ZUNI ST
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City | LOS ALAMOS
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State | NM
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Zip | 87544-2647
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Country | US
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Telephone | 218-310-7222
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Fax |
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. SETH MICHAEL FELICE
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Credential | DPM
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Telephone | 505-500-4301
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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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