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Organization
FAMILY FOOT CARE SPECIALISTS PODIATRY CENTER INC
Active
Organization
FAMILY FOOT CARE SPECIALISTS PODIATRY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL ROBERT KELLEY D.P.M. (OWNER/CEO)
(707) 725-5223
Entity
Organization
Contact information
Practice address
1730 MAIN ST, FORTUNA, CA 95540-2467
(707) 725-5223
(707) 725-2756
Mailing address
1730 MAIN ST, FORTUNA, CA 95540-2467
(707) 725-5223
(707) 725-2756
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
CA
332B00000X
Durable Medical Equipment & Medical Supplies
E2321
CA
Other
Enumeration date
07/15/2006
Last updated
08/29/2014
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