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Organization
ACTIVE FOOT AND ANKLE CARE LLC
Active
Organization
ACTIVE FOOT AND ANKLE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WHITNEY RAE HOLSOPPLE D.P.M (OWNER)
(937) 875-2526
Entity
Organization
Contact information
Practice address
300 S DORSET RD, TROY, OH 45373-2635
(937) 875-2526
(937) 459-5433
Mailing address
300 S DORSET RD, TROY, OH 45373-2635
(937) 875-2526
(937) 459-5433
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36003402
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6077150001
DMERC
OH
Enumeration date
09/21/2012
Last updated
12/17/2019
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