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General NPI Number Information
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NPI Number | 1588023030
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Entity Type | Organization
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Legal Business Name | 1FOOT 2FOOT CENTRE FOR FOOT AND ANKLE CARE, PC
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Dates
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Enumeration Date | 02/12/2016
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 2240 COLISEUM DR STE A
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City | HAMPTON
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State | VA
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Zip | 23666-5903
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Country | US
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Telephone | 579-340-7687
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Fax | 757-925-1901
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Provider Business Mailing Address
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Address Line | 171 N MAIN ST
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City | SUFFOLK
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State | VA
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Zip | 23434-4507
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Country | US
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Telephone | 757-934-0768
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Fax | 757-925-1901
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW C DAIRMAN
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Credential |
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Telephone | 757-934-0768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0103300887
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License Number State | VA
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