Organization
COMMUNITY FOOT AND ANKLE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISAAC TREJO DPM (PODIATRIST/OWNER)
(414) 483-5566
Entity
Organization
Contact information
Practice address
4100 S HOWELL AVE, MILWAUKEE, WI 53207-4410
(414) 483-5566
Mailing address
4100 S HOWELL AVE, MILWAUKEE, WI 53207-4410
(414) 483-5566
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
708
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43267200
—
WI
01
—
480022037
RAILROAD MEDICARE
WI
Enumeration date
11/01/2005
Last updated
02/11/2014
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