Organization
PODIATRY AT HOME, LLC
Active
Parent organization
PODIATRY AT HOME, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PODIATRY AT HOME, LLC
Authorized official
DR. ANDREA EVE GILLIO DPM (DOCTOR, OWNER)
(563) 362-8170
Entity
Organization
Contact information
Practice address
5656 JUDGE RD, BETTENDORF, IA 52722-1211
(563) 362-8170
(872) 333-9156
Mailing address
5656 JUDGE RD, BETTENDORF, IA 52722-1211
(563) 362-8170
(872) 333-9156
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016005330
—
IL
05
—
1134338809
—
IA
Enumeration date
06/17/2021
Last updated
06/17/2021
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