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Portage Podiatry Pc
Foot & Ankle Surgery Podiatrist in Portage, Michigan
NPI 1295996502

Portage Podiatry Pc is a Foot & Ankle Surgery Podiatrist based in Portage, MI and is specialized in Foot & Ankle Surgery. Portage Podiatry Pc practices in Portage, MI. The NPI Number for Portage Podiatry Pc is 1295996502 and holds a License No. 5901001113 (Michigan).

The current practice location address for Portage Podiatry Pc is 1508 W Centre Ave, Portage, MI and can be reached out via phone at 269-327-4447 and via fax at 269-327-3120.

Location: 1508 W Centre Ave, Portage, MI, 49024-5356
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1295996502
Provider Name
Portage Podiatry Pc
Credential
Provider Entity Type
Organization
Address
1508 W Centre Ave, Portage, MI, 49024-5356
Phone Number
269-327-4447
Fax Number
269-327-3120
Provider Enumeration Date
06/19/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1689800 05 MI
institution
Provider Business Practice Location Address Details
Address
1508 W Centre Ave
City
Portage
State
Michigan
Zip
49024-5356
Phone Number
269-327-4447
Fax Number
269-327-3120
person
Provider Business Mailing Address Details
Address
1508 W Centre Ave
City
Portage
State
Michigan
Zip
49024-5356
Phone Number
269-327-4447
Fax Number
269-327-3120
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
5901001113 (Michigan)
Definition
Definition to come...
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