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General NPI Number Information
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NPI Number | 1770946360
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Entity Type | Organization
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Legal Business Name | BEST FOOT AND ANKLE CARE LLC
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Dates
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Enumeration Date | 03/31/2016
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 6001 W CENTER ST SUITE 108
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City | MILWAUKEE
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State | WI
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Zip | 53210-2154
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Country | US
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Telephone | 414-861-0526
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 370792
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City | MILWAUKEE
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State | WI
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Zip | 53237-1892
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAHIR A KHAN
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Credential | DPM
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Telephone | 414-861-0526
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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 | 1049-25
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License Number State | WI
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