# SOUTHWEST FAMILY FOOTCARE SPECIALIST, LLC

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

## Provider details

- **NPI number:** 1326236514
- **Authorized official:** DR. REGINA LYNNE SPEARS D.P.M. (PRESIDENT)
- **Authorized official phone:** (269) 639-1115

## Contact information

- **Practice address:** 10570 BLUE STAR M HWY, SOUTH HAVEN, MI 49090-8923
- **Practice address phone:** (269) 639-1115
- **Practice address fax:** (269) 639-2525
- **Mailing address:** PO BOX 2078, PORTAGE, MI 49081-2078
- **Mailing address phone:** (269) 639-1115
- **Mailing address fax:** (269) 639-2525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 5901001629 | MI | Yes |

## Other

- **Enumeration date:** 10/12/2007
- **Last updated:** 12/04/2007