Organization
WHITE MOUNTAIN FOOT AND ANKLE CARE CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
H RYAN HALL DPM (PRESIDENT)
(928) 367-3701
Entity
Organization
Contact information
Practice address
5448 WHITE MOUNTAIN BLVD, SUITE 270, LAKESIDE, AZ 85929-5739
(928) 532-1122
(928) 532-1124
Mailing address
PO BOX 39, OVERGAARD, AZ 85933-0039
(928) 532-1122
(928) 532-1124
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
640
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087223
—
AZ
Enumeration date
08/16/2007
Last updated
12/12/2008
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