Provider Demographics
NPI:1659626265
Name:AT HOME PODIATRY, LLC
Entity Type:Organization
Organization Name:AT HOME PODIATRY, LLC
Other - Org Name:AHP FOOT & WOUND CARE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:317-847-1558
Mailing Address - Street 1:9011 N MERIDIAN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5378
Mailing Address - Country:US
Mailing Address - Phone:317-218-4095
Mailing Address - Fax:877-476-7125
Practice Address - Street 1:9011 N MERIDIAN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5378
Practice Address - Country:US
Practice Address - Phone:317-847-1558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-19
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty