# ADVANCED FOOT & ANKLE CENTER LLC

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

## Provider details

- **NPI number:** 1972875854
- **Authorized official:** CYNTHIA GRUNDY DPM (DOCTOR)
- **Authorized official phone:** (219) 405-3775

## Contact information

- **Practice address:** 111 BOYD CIR, MICHIGAN CITY, IN 46360-7016
- **Practice address phone:** (219) 405-3775
- **Practice address fax:** (219) 405-3775
- **Mailing address:** 27 ASPEN RD, PORTAGE, IN 46368-1027
- **Mailing address phone:** (219) 405-3775
- **Mailing address fax:** (219) 405-3775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 07000941A | IN | Yes |

## Other

- **Enumeration date:** 02/07/2012
- **Last updated:** 09/12/2019