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Organization
ON THE MOVE PODIATRY LLC
Active
Organization
ON THE MOVE PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY FERRULLI (OFFICE MANAGER)
(602) 993-2700
Entity
Organization
Contact information
Practice address
19636 N 27TH AVE STE 207, PHOENIX, AZ 85027-4015
(602) 993-2700
Mailing address
19636 N 27TH AVE STE 301, PHOENIX, AZ 85027-4016
(602) 993-2700
(602) 993-2705
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
261QP1100X
Podiatric Clinic/Center
—
NULL
Other
Enumeration date
05/10/2021
Last updated
02/16/2022
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