Organization
FAMILY PODIATRY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVECCA SHAW (PODIATRIST/OWNER)
(216) 798-6731
Entity
Organization
Contact information
Practice address
9850 VON ALLMEN CT, LOUISVILLE, KY 40241
(216) 798-6731
Mailing address
11519 WILLOW STREAM CT APT 201, LOUISVILLE, KY 40299-5987
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00338
KY
Other
Enumeration date
03/09/2018
Last updated
07/19/2018
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