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General NPI Number Information
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NPI Number | 1780196279
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Entity Type | Organization
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Legal Business Name | JANET'S PROFESSIONAL FOOT CARE INC
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 255 HIGHWAY 97
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City | FOREST LAKE
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State | MN
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Zip | 55025-2697
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Country | US
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Telephone | 651-231-8425
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Fax |
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Provider Business Mailing Address
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Address Line | 33196 FOREST BLVD
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City | STACY
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State | MN
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Zip | 55079-9513
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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 | RN
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Name | JANET FREDA HORSFALL
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Credential | RN
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Telephone | 651-231-8425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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