Provider Demographics
NPI:1659796332
Name:THE FOOT CARE CENTER, LLC
Entity Type:Organization
Organization Name:THE FOOT CARE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAWS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:406-252-5444
Mailing Address - Street 1:3990 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-7531
Mailing Address - Country:US
Mailing Address - Phone:406-252-5444
Mailing Address - Fax:406-245-9043
Practice Address - Street 1:3990 AVENUE D
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7531
Practice Address - Country:US
Practice Address - Phone:406-252-5444
Practice Address - Fax:406-245-9043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT165213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4821300003Medicare NSC