MEDICARE: FAMILY FOOTCARE OF MID-MICHIGAN, 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	261QP1100X	Podiatric Clinic/Center	5901001836	MI

General Provider Information

NPI Number	:	1851586515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY FOOTCARE OF MID-MICHIGAN, P.C.

Provider Business Mailing Address
First Line	:	1205 S MISSION ST
Second Line	:	STE. 11
City	:	MOUNT PLEASANT
State	:	MI
Zip	:	48858-3939
Country	:	US
Telephone Number	:	989-775-8500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 S MISSION ST
Second Line	:	STE. 11
City	:	MOUNT PLEASANT
State	:	MI
Zip	:	48858-3939
Country	:	US
Telephone Number	:	989-775-8500
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CONNIE L BILLS
Credential	:	DPM
Telephone Number	:	989-775-8500

Provider Enumeration Date	:	09/06/2007
Last Update Date	:	06/11/2008

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