Organization
HAGGARDDPM HOME FOOT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN HAGGARD DPM (SOLE MEMBER)
(253) 334-5262
Entity
Organization
Contact information
Practice address
210 27TH AVE APT F105, MILTON, WA 98354-8330
(253) 334-5262
(253) 815-1651
Mailing address
PO BOX 506, MILTON, WA 98354-0506
(253) 334-5262
(253) 815-1651
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063510
—
WA
Enumeration date
11/26/2019
Last updated
11/26/2019
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