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General NPI Number Information
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NPI Number | 1992775787
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Entity Type | Organization
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Legal Business Name | MONROE FOOT CLINIC SC
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 09/12/2013
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Provider Practice Location Address
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Address Line | 1500 11TH ST
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City | MONROE
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State | WI
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Zip | 53566
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Country | US
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Telephone | 608-325-9175
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Fax | 608-325-9176
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Provider Business Mailing Address
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Address Line | 1500 11TH ST
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City | MONROE
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State | WI
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Zip | 53566
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Country | US
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Telephone | 608-325-9175
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Fax | 608-325-9176
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Authorized Official
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Title or Position | DR OWNER
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Name | DR. CHARLES F KIND
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Credential | DPM
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Telephone | 608-325-9175
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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 | 712025
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License Number State | WI
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