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General NPI Number Information
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NPI Number | 1760662449
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE FOOT CENTERS P.A.
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 11/09/2007
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Provider Practice Location Address
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Address Line | 17201 E 40 HWY SUITE 103
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City | INDEPENDENCE
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State | MO
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Zip | 64055-6400
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Country | US
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Telephone | 816-455-1155
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Fax | 816-455-1161
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Provider Business Mailing Address
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Address Line | 550 RUSH CREEK PKWY SUITE A
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City | LIBERTY
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State | MO
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Zip | 64068-9604
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Country | US
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Telephone | 816-455-1155
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Fax | 816-455-1161
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. RISHONA JONES
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Credential |
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Telephone | 816-455-1155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 000575
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License Number State | MO
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