Provider Demographics
NPI:1225238025
Name:AMBULATORY FOOT SURGERY CENTER LTD
Entity Type:Organization
Organization Name:AMBULATORY FOOT SURGERY CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HOFFMAN
Authorized Official - Last Name:ZITTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-526-9394
Mailing Address - Street 1:420 EAST GREEN BAY STREET
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-2500
Mailing Address - Country:US
Mailing Address - Phone:715-526-9394
Mailing Address - Fax:
Practice Address - Street 1:420 EAST GREEN BAY STREET
Practice Address - Street 2:
Practice Address - City:SHAWANO
Practice Address - State:WI
Practice Address - Zip Code:54166-2500
Practice Address - Country:US
Practice Address - Phone:715-526-9394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty