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Organization
PEDORTHIC CONCEPTS, INC
Active
Organization
PEDORTHIC CONCEPTS, INC
Active
Other names
The FootCare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID GLENN FORD C.PED (PRESIDENT)
(205) 823-5580
Entity
Organization
Contact information
Practice address
3021 LORNA RD, SUITE 300, BIRMINGHAM, AL 35216-4587
(205) 823-5580
(205) 823-5590
Mailing address
3021 LORNA RD, SUITE 300, BIRMINGHAM, AL 35216-4587
(205) 823-5580
(205) 823-5590
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51514840
BLUE CROSS BLUE SHIELD
AL
Enumeration date
10/24/2006
Last updated
08/22/2020
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