Organization
PERSONAL FOOTCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL WINFRED PERSON D.P.M. (PRESIDENT)
(804) 732-1211
Entity
Organization
Contact information
Practice address
2020 WAKEFIELD AVE, PETERSBURG, VA 23805-2112
(804) 732-1211
(804) 733-5946
Mailing address
2020 WAKEFIELD AVE, PETERSBURG, VA 23805-2112
(804) 732-1211
(804) 733-5946
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
0103000377
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009331409
—
VT
05
—
30015176580001
—
VA
05
—
30015890910001
—
VA
Enumeration date
03/22/2006
Last updated
05/18/2024
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