NPI 1336327642 · live from the CMS NPI Registry
Area Wide Foot & Ankle Center, P.C.
Clinic/Center, Podiatric in Bettendorf, IA. National Provider Identifier 1336327642, active.
NPI record
| NPI | 1336327642 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Podiatric 261QP1100X |
| Practice location | 1967 Spruce Hills Dr, Bettendorf, IA 52722 |
| Practice phone | 563-441-0117 |
| Enumerated | February 8, 2008 |
| Last updated | March 8, 2008 |
| Authorized official | Jim Licandro, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | 00705 (IA) |
| Clinic/Center, Podiatric primary | 261QP1100X | 00705 (IA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.