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General NPI Number Information
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NPI Number | 1902014491
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Entity Type | Organization
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Legal Business Name | BIOMECHANICAL PODIATRY PC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 10789 N 90TH ST SUITE 103
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6773
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Country | US
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Telephone | 480-451-0123
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Fax | 480-451-4876
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Provider Business Mailing Address
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Address Line | 10789 N 90TH ST SUITE 103
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6773
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Country | US
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Telephone | 480-451-0123
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Fax | 480-451-4876
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. WILLIAM J ACCOMANDO
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Credential | D.P.M.
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Telephone | 480-451-0123
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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 | 338
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License Number State | AZ
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