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Organization
COMMONWEALTH FOOT AND ANKLE CARE LLC
Active
Organization
COMMONWEALTH FOOT AND ANKLE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BENGE DPM (OWNER)
(270) 598-4910
Entity
Organization
Contact information
Practice address
1030 BROOKHAVEN RD, FRANKLIN, KY 42134-2745
(270) 598-4910
(270) 598-4930
Mailing address
1945 SCOTTSVILLE RD, B-2 PMB 109, BOWLING GREEN, KY 42104-3376
(270) 598-4910
(270) 598-4930
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00337
KY
332B00000X
Durable Medical Equipment & Medical Supplies
00337
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100161590
—
KY
05
—
7100204290
—
KY
Enumeration date
04/21/2011
Last updated
03/22/2016
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