Organization
GOLDEN AGE FOOTCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOREMY LY DPM (PRESIDENT)
(816) 304-8452
Entity
Organization
Contact information
Practice address
323 S. 169 HIGHWAY, GOWER, MO 64454-9116
(816) 304-8452
(816) 468-0742
Mailing address
7818 N HULL AVE, KANSAS CITY, MO 64151-1532
(816) 304-8452
(816) 468-0742
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Enumeration date
05/27/2009
Last updated
05/27/2009
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