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General NPI Number Information
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NPI Number | 1740480359
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Entity Type | Organization
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Legal Business Name | FOOTOMAKI TUCSON
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Dates
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Enumeration Date | 07/21/2007
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Last Update Date | 11/12/2008
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Provider Practice Location Address
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Address Line | 4444 E GRANT RD # 115
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City | TUCSON
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State | AZ
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Zip | 85712
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Country | US
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Telephone | 520-795-8650
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Fax | 520-795-8687
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Provider Business Mailing Address
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Address Line | 4444 E GRANT RD # 115
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City | TUCSON
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State | AZ
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Zip | 85712
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Country | US
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Telephone | 520-795-8650
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Fax | 520-795-8687
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Authorized Official
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Title or Position | MANAGER
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Name | RITA M GIFFIN
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Credential | CPED
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Telephone | 520-795-8650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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