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General NPI Number Information
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NPI Number | 1659366029
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Entity Type | Organization
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Legal Business Name | NORTHERN INDIANA FOOT & ANKLE ASSOC INC
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 504 COLONIAL COURT
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City | PLYMOUTH
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State | IN
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Zip | 46563-1860
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Country | US
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Telephone | 574-935-5563
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Fax | 574-935-0015
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Provider Business Mailing Address
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Address Line | 504 COLONIAL CT
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City | PLYMOUTH
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State | IN
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Zip | 46563-1860
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Country | US
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Telephone | 574-935-5563
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Fax | 574-935-0015
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. MARCI A ZIELINSKI
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Credential |
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Telephone | 574-935-5563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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