# ACTIVE FOOT AND ANKLE CARE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1164773875
- **Authorized official:** WHITNEY RAE HOLSOPPLE D.P.M (OWNER)
- **Authorized official phone:** (937) 875-2526

## Contact information

- **Practice address:** 300 S DORSET RD, TROY, OH 45373-2635
- **Practice address phone:** (937) 875-2526
- **Practice address fax:** (937) 459-5433
- **Mailing address:** 300 S DORSET RD, TROY, OH 45373-2635
- **Mailing address phone:** (937) 875-2526
- **Mailing address fax:** (937) 459-5433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 36003402 | OH | Yes |

## Other

- **Enumeration date:** 09/21/2012
- **Last updated:** 12/17/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 6077150001 | DMERC | OH |