MEDICARE: KALISPELL FOOT & ANKLE CLINIC, PC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BC3200X	Customized Equipment (DME)
3	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1770948929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KALISPELL FOOT & ANKLE CLINIC, PC

Provider Business Mailing Address
First Line	:	58 VILLAGE LOOP RD
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-2793
Country	:	US
Telephone Number	:	406-755-5250
Fax Number	:	406-755-5251

Provider Business Practice Location Address
First Line	:	58 VILLAGE LOOP RD
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-2793
Country	:	US
Telephone Number	:	406-755-5250
Fax Number	:	406-755-5251

Authorized Official
Title or Position	:	PODIATRIST
Name	:	BENJAMIN WEBB
Credential	:	DPM
Telephone Number	:	406-755-5250

Provider Enumeration Date	:	12/15/2015
Last Update Date	:	05/28/2026

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