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General NPI Number Information
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NPI Number | 1831365238
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Entity Type | Organization
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Legal Business Name | ALLIED PODIATRY, INC
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 12/10/2009
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Provider Practice Location Address
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Address Line | 1400 S MAIN ST SUITES A & B
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-1581
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Country | US
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Telephone | 419-763-1035
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Fax | 419-763-1128
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Provider Business Mailing Address
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Address Line | 1400 S MAIN ST SUITES A & B
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-1581
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Country | US
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Telephone | 419-763-1035
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Fax | 419-763-1128
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Authorized Official
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Title or Position | BILLER
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Name | TARA A HOMAN
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Credential |
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Telephone | 419-763-1035
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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 | 36.003384
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License Number State | OH
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