Organization
COMFORT FOOT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO S DICKENS DPM (OWNER)
(423) 710-1224
Entity
Organization
Contact information
Practice address
6116 SHALLOWFORD RD, STE 118, CHATTANOOGA, TN 37421-7201
(423) 710-1224
(423) 710-1228
Mailing address
6116 SHALLOWFORD RD, STE 118, CHATTANOOGA, TN 37421-7201
(423) 710-1224
(423) 710-1228
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DPM0000000690
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1514424
—
TN
01
—
DP2921
RAILROAD MEDICARE
—
Enumeration date
04/22/2009
Last updated
08/18/2010
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