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NPI Code Detail

MEDICARE: ESSENTIAL FOOTCARE SERVICES INC

MEDICARE: ESSENTIAL FOOTCARE SERVICES 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
1251E00000XHome Health Agency348705MN

General Provider Information

NPI Number : 1891001798
Entity Type Code : Organization
Provider Name (Legal Business Name) : ESSENTIAL FOOTCARE SERVICES INC
Provider Business Mailing Address
First Line : 2527 CLAREMONT DR
Second Line :
City : MENDOTA HEIGHTS
State : MN
Zip : 55120-1726
Country : US
Telephone Number : 651-262-4793
Fax Number : 651-207-5982
Provider Business Practice Location Address
First Line : 2527 CLAREMONT DR
Second Line :
City : MENDOTA HEIGHTS
State : MN
Zip : 55120-1726
Country : US
Telephone Number : 651-262-4793
Fax Number : 651-207-5982
Authorized Official
Title or Position : OWNER
Name : JOANNE FOUNTAINE
Credential : LPN
Telephone Number : 651-262-4793
Provider Enumeration Date : 08/30/2010
Last Update Date : 08/30/2010

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Directions to “ESSENTIAL FOOTCARE SERVICES INC ” Practice Location

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