Provider Demographics
NPI:1407564545
Name:FOOT HEALTHCARE ASSOCIATES P.C.
Entity Type:Organization
Organization Name:FOOT HEALTHCARE ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-258-0001
Mailing Address - Street 1:37595 7 MILE RD STE 370
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1489
Mailing Address - Country:US
Mailing Address - Phone:248-258-0001
Mailing Address - Fax:248-258-6779
Practice Address - Street 1:1225 S LATSON RD STE 320
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-7661
Practice Address - Country:US
Practice Address - Phone:248-258-0001
Practice Address - Fax:248-258-6779
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOOT HEALTHCARE ASSOCIATES P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty