Provider Demographics
NPI:1518327261
Name:FLATHEAD FAMILY FOOT CARE PC
Entity Type:Organization
Organization Name:FLATHEAD FAMILY FOOT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CLASE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:406-730-3669
Mailing Address - Street 1:715 NUCLEUS AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-4015
Mailing Address - Country:US
Mailing Address - Phone:406-730-3669
Mailing Address - Fax:406-730-3667
Practice Address - Street 1:715 NUCLEUS AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-4015
Practice Address - Country:US
Practice Address - Phone:406-730-3669
Practice Address - Fax:406-730-3667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT25643213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty