Organization · NPI-2

Active Foot And Ankle Center, PC

Podiatrist, Foot & Ankle Surgery · Chesapeake, VA

NPI number1326453499
StatusActive
Last updated in NPPESOct 17, 2023

Details

NPI
1326453499
Entity type
Organization (NPI-2)
Legal business name
Active Foot And Ankle Center, PC
Organization subpart
No
Enumeration date
Jun 26, 2014
Certification date
Oct 17, 2023
Last updated
Oct 17, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213ES0103X Podiatrist, Foot & Ankle Surgery–VAYes

Practice location

369 Johnstown Rd
Chesapeake, VA 23322-5309

Phone 757-547-0123 · Fax 757-547-2412

Mailing address

369 Johnstown Rd
Chesapeake, VA 23322-5309

Phone 757-547-0123 · Fax 757-547-2412

Authorized official

Sandra Blankenship Henderson
Office Manager
7575470123

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