Organization
SOUTHWEST FAMILY FOOTCARE SPECIALIST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINA LYNNE SPEARS D.P.M. (PRESIDENT)
(269) 639-1115
Entity
Organization
Contact information
Practice address
10570 BLUE STAR M HWY, SOUTH HAVEN, MI 49090-8923
(269) 639-1115
(269) 639-2525
Mailing address
PO BOX 2078, PORTAGE, MI 49081-2078
(269) 639-1115
(269) 639-2525
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901001629
MI
Other
Enumeration date
10/12/2007
Last updated
12/04/2007
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