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General NPI Number Information
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NPI Number | 1508046335
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Entity Type | Organization
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Legal Business Name | JOHN W BREMYER PODIATRY INC
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 481 WEST PERRY ST SUITE D
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City | TIFFIN
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State | OH
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Zip | 44883-4115
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Country | US
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Telephone | 419-447-9685
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Fax | 419-447-8900
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Provider Business Mailing Address
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Address Line | 481 WEST PERRY ST SUITE D
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City | TIFFIN
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State | OH
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Zip | 44883-4115
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Country | US
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Telephone | 419-447-9685
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Fax | 419-447-8900
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN W BREMYER
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Credential | DPM
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Telephone | 419-447-9685
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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 | 36002545
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License Number State | OH
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