Provider Demographics
NPI:1437301108
Name:ANKLE AND FOOT CARE INC
Entity Type:Organization
Organization Name:ANKLE AND FOOT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANTY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:724-543-3668
Mailing Address - Street 1:186 BLANCY ROAD
Mailing Address - Street 2:
Mailing Address - City:KITTANNINA
Mailing Address - State:PA
Mailing Address - Zip Code:16201
Mailing Address - Country:US
Mailing Address - Phone:724-543-3668
Mailing Address - Fax:724-543-2087
Practice Address - Street 1:180 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202
Practice Address - Country:US
Practice Address - Phone:412-734-3200
Practice Address - Fax:412-734-9238
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANKLE AND FOOT CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004665L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========Medicaid
PA=========Medicaid
PAU80551Medicare UPIN