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General NPI Number Information
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NPI Number | 1467654897
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Entity Type | Organization
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Legal Business Name | ADVANCED FOOT & ANKLE LTD
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 3667 REFLECTION DR
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City | PRESCOTT
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State | AZ
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Zip | 86305-7188
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Country | US
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Telephone | 928-530-3230
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10634
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City | PRESCOTT
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State | AZ
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Zip | 86304-0634
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Country | US
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Telephone | 928-530-3230
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | RON ANTHON OLSEN
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Credential | D.P.M.
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Telephone | 928-530-3230
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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 |
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License Number State |
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