Provider Demographics
NPI:1780196279
Name:JANET'S PROFESSIONAL FOOT CARE INC
Entity Type:Organization
Organization Name:JANET'S PROFESSIONAL FOOT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:FREDA
Authorized Official - Last Name:HORSFALL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:651-231-8425
Mailing Address - Street 1:33196 FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:STACY
Mailing Address - State:MN
Mailing Address - Zip Code:55079-9513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:255 HIGHWAY 97
Practice Address - Street 2:
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-2697
Practice Address - Country:US
Practice Address - Phone:651-231-8425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health