Organization
COMPLETE FOOT AND ANKLE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNE PETRAS (CREDENTIALING)
(304) 737-7016
Entity
Organization
Contact information
Practice address
1512 COMMERCE ST, WELLSBURG, WV 26070-1323
(304) 737-2964
(304) 737-4822
Mailing address
1512 COMMERCE ST, WELLSBURG, WV 26070-1323
(740) 282-0861
(304) 737-2964
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00376
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285657460
INDIVIDUAL NPI
—
05
—
3810019307
—
WV
Enumeration date
12/17/2014
Last updated
07/09/2024
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