MEDICARE: LIGHTFOOT PODIATRY CENTER, INC

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	261QP1100X	Podiatric Clinic/Center		VA

General Provider Information

NPI Number	:	1598941106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHTFOOT PODIATRY CENTER, INC

Provider Business Mailing Address
First Line	:	213 BULIFANTS BLVD STE A
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-5733
Country	:	US
Telephone Number	:	757-345-3679
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 BULIFANTS BLVD STE A
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-5733
Country	:	US
Telephone Number	:	757-345-3679
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARC GARFIELD
Credential	:	D.P.M.
Telephone Number	:	757-345-3679

Provider Enumeration Date	:	01/14/2008
Last Update Date	:	07/27/2009

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