Broadway Foot Clinic Corporation

NPI 1073510244 - Podiatrist - 213E00000X

NPI Details
NPI 1073510244
Enumeration Date 07/03/2005
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 12 years ago
Authorized Information
Name SONNY O SONNY
Position VICE PRESIDENT
Phone (219) 884-7880
Fax (219) 884-7880
Practice Location
3290 GRANT ST
SUITE 108
GARY IN, 46408-1015, US
Phone (219) 884-7880
Fax (219) 884-7880
Business Location
3290 GRANT ST
SUITE 108
GARY IN, 46408-1015, US
Phone (219) 884-7880
Fax (219) 884-7880
Toxanomy
Taxonomy Code 213E00000X
License State Indiana
License Number 07000445A
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According to our database, Broadway Foot Clinic Corporation NPI is 1073510244, taxonomy code is 213E00000X and license number is 07000445A, license state is located at Indiana. Broadway Foot Clinic Corporation physically located at 3290 Grant St, Gary IN, 46408-1015. NPI Number 1033115704 has the healthcare provider type.

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1073510244 NPI number is provided on an as is basis without warranty of any kind. 1073510244 is maintained by the National Plan & Provider Enumeration System. The contents of Broadway Foot Clinic Corporation are for informational purposes only.