Organization
PEDORTHIC CONCEPTS, INC
Active
Other names
The FootCare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID GLENN FORD C.PED (PRESIDENT)
(205) 823-5580
Entity
Organization
Contact information
Practice address
3021 LORNA RD, SUITE 300, BIRMINGHAM, AL 35216-4587
(205) 823-5580
(205) 823-5590
Mailing address
3021 LORNA RD, SUITE 300, BIRMINGHAM, AL 35216-4587
(205) 823-5580
(205) 823-5590
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51514840
BLUE CROSS BLUE SHIELD
AL
Enumeration date
10/24/2006
Last updated
08/22/2020
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