Provider Demographics
NPI:1164586202
Name:NORTHERN FOOT & ANKLE CENTERS P.C.
Entity Type:Organization
Organization Name:NORTHERN FOOT & ANKLE CENTERS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-354-3309
Mailing Address - Street 1:321 LONG RAPIDS PLZ
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-1375
Mailing Address - Country:US
Mailing Address - Phone:989-354-3309
Mailing Address - Fax:989-354-9190
Practice Address - Street 1:321 LONG RAPIDS PLZ
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1375
Practice Address - Country:US
Practice Address - Phone:989-354-3309
Practice Address - Fax:989-354-9190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4140770001Medicare NSC