Provider Demographics
NPI:1922637107
Name:TORHORST FOOT AND ANKLE CLINIC, SC
Entity Type:Organization
Organization Name:TORHORST FOOT AND ANKLE CLINIC, SC
Other - Org Name:TORHORST FOOT AND ANKLE CLINIC, S.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:TORHORST
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:715-498-6266
Mailing Address - Street 1:2220 TIMBERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-9200
Mailing Address - Country:US
Mailing Address - Phone:715-498-1051
Mailing Address - Fax:
Practice Address - Street 1:2823 POST RD
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-6416
Practice Address - Country:US
Practice Address - Phone:715-498-6266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI7696990002OtherMEDICARE DME