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General NPI Number Information
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NPI Number | 1952404964
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Entity Type | Organization
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Legal Business Name | PREMIER FOOTCARE PC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 09/27/2019
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Provider Practice Location Address
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Address Line | 131 FRENCH LANDING DR
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City | NASHVILLE
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State | TN
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Zip | 37228-1511
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Country | US
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Telephone | 615-321-2711
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Fax | 615-534-4784
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Provider Business Mailing Address
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Address Line | PO BOX 11573
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City | MURFREESBORO
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State | TN
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Zip | 37129-0032
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Country | US
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Telephone | 615-321-2711
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Fax | 615-534-4784
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. LARELYN T CREAR
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Credential | DPM
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Telephone | 615-321-2711
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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 | 619TN
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License Number State | TN
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