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General NPI Number Information
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NPI Number | 1750442521
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Entity Type | Organization
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Legal Business Name | ALABAMA FOOT CARE CENTER, PC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 2304 GATEWAY DR STE B
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City | OPELIKA
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State | AL
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Zip | 36801-7273
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Country | US
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Telephone | 334-741-7600
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Fax | 847-241-7600
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Provider Business Mailing Address
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Address Line | 2304 GATEWAY DR STE B
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City | OPELIKA
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State | AL
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Zip | 36801-7273
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Country | US
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Telephone | 334-741-7600
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Fax | 847-241-7600
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Authorized Official
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Title or Position | OWNER
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Name | PAUL J CIAVARELLI JR.
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Credential | DPM
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Telephone | 334-741-7600
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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 | 179
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License Number State | AL
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