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General NPI Number Information
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NPI Number | 1659527893
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Entity Type | Organization
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Legal Business Name | THE FOOT & ANKLE INSTITUTE LLC
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 340 FALCON RIDGE PKWY BUILDING 300, SUITE A
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City | MESQUITE
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State | NV
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Zip | 89027-8850
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Country | US
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Telephone | 702-346-7678
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Fax | 702-346-1623
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Provider Business Mailing Address
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Address Line | 340 FALCON RIDGE PKWY BUILDING 300, SUITE A
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City | MESQUITE
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State | NV
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Zip | 89027-8850
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Country | US
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Telephone | 702-346-7678
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Fax | 702-346-1623
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. BRENT L DAVIS
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Credential |
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Telephone | 435-628-2671
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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 | 78902GR
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License Number State | NV
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