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General NPI Number Information
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NPI Number | 1881817161
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Entity Type | Organization
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Legal Business Name | ACHILLES FOOT AND ANKLE CLINIC SC
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 728 ELM STREET
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City | WOODRUFF
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State | WI
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Zip | 54568
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Country | US
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Telephone | 715-358-9777
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Fax | 715-358-9737
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Provider Business Mailing Address
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Address Line | PO BOX 528 728 ELM STREET
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City | WOODRUFF
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State | WI
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Zip | 54568
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Country | US
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Telephone | 715-358-9777
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Fax | 715-358-9737
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MINDY LEE WOLF
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Credential | DPM
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Telephone | 715-358-9777
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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 |
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License Number State |
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