Organization
COMMONWEALTH FOOT AND ANKLE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BENGE DPM (OWNER)
(270) 598-4910
Entity
Organization
Contact information
Practice address
1030 BROOKHAVEN RD, FRANKLIN, KY 42134-2745
(270) 598-4910
(270) 598-4930
Mailing address
1945 SCOTTSVILLE RD, B-2 PMB 109, BOWLING GREEN, KY 42104-3376
(270) 598-4910
(270) 598-4930
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00337
KY
332B00000X
Durable Medical Equipment & Medical Supplies
00337
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100161590
—
KY
05
—
7100204290
—
KY
Enumeration date
04/21/2011
Last updated
03/22/2016
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