Provider Demographics
NPI:1831477868
Name:1FOOT 2FOOT CENTRE FOR FOOT AND ANKLE CARE, PC
Entity Type:Organization
Organization Name:1FOOT 2FOOT CENTRE FOR FOOT AND ANKLE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:C
Authorized Official - Last Name:DAIRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-934-0768
Mailing Address - Street 1:171 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4507
Mailing Address - Country:US
Mailing Address - Phone:757-934-0768
Mailing Address - Fax:757-925-1901
Practice Address - Street 1:5839 HARBOUR VIEW BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3797
Practice Address - Country:US
Practice Address - Phone:757-934-0768
Practice Address - Fax:757-925-1901
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1FOOT 2FOOT CENTRE FOR FOOT AND ANKLE CARE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-25
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies