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Organization
KIRK M BOTT DBA LOGAN AVENUE FOOT CLINIC
Active
Organization
KIRK M BOTT DBA LOGAN AVENUE FOOT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK M BOTT DPM (OWNER)
(217) 442-4186
Entity
Organization
Contact information
Practice address
612 N LOGAN AVENUE, DANVILLE, IL 61832
(217) 442-4186
Mailing address
612 N LOGAN AVENUE, DANVILLE, IL 61832
(217) 442-4186
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016003907
IL
Other
Enumeration date
05/03/2007
Last updated
06/18/2008
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