# PEACE RIVER ANKLE & FOOT, PL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023329331
- **Authorized official:** DR. HOLLY K WADDELL DPM (OWNER/PODIATRIST)
- **Authorized official phone:** (941) 624-3668

## Contact information

- **Practice address:** 3440 CONWAY BLVD, 1D, PORT CHARLOTTE, FL 33952-7000
- **Practice address phone:** (941) 624-3668
- **Mailing address:** 3440 CONWAY BLVD, 1D, PORT CHARLOTTE, FL 33952-7000
- **Mailing address phone:** (941) 624-3668

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO3264 | FL | Yes |

## Other

- **Enumeration date:** 07/01/2010
- **Last updated:** 03/03/2011