Organization
HEAVENLY SOLES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIE C PAUL DPM (MANAGER)
(623) 584-0760
Entity
Organization
Contact information
Practice address
13954 W WADDELL RD, SUITE 307, SURPRISE, AZ 85379-8750
(623) 584-0760
(623) 546-0344
Mailing address
13954 W WADDELL RD, SUITE 307, SURPRISE, AZ 85379-8750
(623) 584-0760
(623) 546-0344
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
0711
AZ
261QP1100X
Podiatric Clinic/Center
0711
AZ
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
0711
AZ
311500000X
Alzheimer Center (Dementia Center)
0711
AZ
311ZA0620X
Adult Care Home Facility
0711
AZ
313M00000X
Nursing Facility/Intermediate Care Facility
0711
AZ
Other
Enumeration date
02/27/2014
Last updated
11/08/2016
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