Organization
DAT FS2 INC
Active
Other names
Foot Solutions Litchfield Park
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOMM O KLEYENSTEUBER (OWNER)
(623) 628-1001
Entity
Organization
Contact information
Practice address
6359 W REDFIELD RD, GLENDALE, AZ 85306-3765
(623) 776-0430
(623) 776-0643
Mailing address
6359 W REDFIELD RD, GLENDALE, AZ 85306-3765
(623) 776-0430
(623) 776-0643
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
20085770
AZ
Other
Enumeration date
04/19/2007
Last updated
08/30/2007
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