MEDICARE: PERSONAL FOOT CARE, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	229	AL

General Provider Information

NPI Number	:	1063680775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL FOOT CARE, P.C.

Provider Business Mailing Address
First Line	:	546 MCQUEEN SMITH RD N
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36066-5558
Country	:	US
Telephone Number	:	334-358-9765
Fax Number	:	334-358-5434

Provider Business Practice Location Address
First Line	:	546 MCQUEEN SMITH RD N
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36066-5558
Country	:	US
Telephone Number	:	334-358-9765
Fax Number	:	334-358-5434

Authorized Official
Title or Position	:	PRESIDENT/ OWNER
Name	:	DR. BRIAN JOSEPH ZAGAR
Credential	:	D.P.M.
Telephone Number	:	334-358-9765

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	02/15/2008

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