Provider Demographics
NPI:1508101098
Name:ACCESS FOOT CARE, PC
Entity Type:Organization
Organization Name:ACCESS FOOT CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERPOOL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:515-252-1550
Mailing Address - Street 1:7517 DOUGLAS AVE
Mailing Address - Street 2:SUITE #15
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-3075
Mailing Address - Country:US
Mailing Address - Phone:515-252-1550
Mailing Address - Fax:515-252-8886
Practice Address - Street 1:7517 DOUGLAS AVE
Practice Address - Street 2:SUITE #15
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-3075
Practice Address - Country:US
Practice Address - Phone:515-252-1550
Practice Address - Fax:515-252-8886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00590261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center