Organization · NPI-2

Podiatry Home Care LLC

Podiatrist, Primary Podiatric Medicine · Norfolk, VA

NPI number1750730628
StatusActive
Last updated in NPPESJun 28, 2016

Details

NPI
1750730628
Entity type
Organization (NPI-2)
Legal business name
Podiatry Home Care LLC
Organization subpart
No
Enumeration date
Jun 10, 2016
Last updated
Jun 28, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213EP1101X Podiatrist, Primary Podiatric Medicine0103000695VAYes

Practice location

1567 Aspin Ave
Suite B
Norfolk, VA 23502-1532

Phone 757-965-4765 · Fax 757-965-4765

Mailing address

7750 Ogden Ave
Apt A
Norfolk, VA 23505-2069

Phone 100-000-0000 · Fax 757-965-4765

Authorized official

Edna Holmes
Owner
1000000000

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