Organization
CHARLOTTE COUNTY FOOT CLINICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE A BUSH (MANAGER)
(954) 479-0481
Entity
Organization
Contact information
Practice address
2866 TAMIAMI TRL, STE C, PORT CHARLOTTE, FL 33952-5126
(941) 629-3535
(941) 625-2076
Mailing address
2866 TAMIAMI TRL, STE C, PORT CHARLOTTE, FL 33952-5126
(941) 629-3535
(941) 625-2076
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO3373
FL
Other
Enumeration date
01/08/2017
Last updated
01/08/2017
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