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Organization
WTFOOTCARE, PROFESSIONAL PHYSICIAN ASSISTANT CORPORATION
Active
Organization
WTFOOTCARE, PROFESSIONAL PHYSICIAN ASSISTANT CORPORATION
Active
Other names
WTFootcare, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE CLARK-POVEDA PA (PA)
(909) 732-8811
Entity
Organization
Contact information
Practice address
8972 APPALOOSA CT, RANCHO CUCAMONGA, CA 91737-1401
(909) 274-9143
Mailing address
8972 APPALOOSA CT, RANCHO CUCAMONGA, CA 91737-1401
(909) 274-9143
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/08/2020
Last updated
07/28/2020
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