Organization
AMES FOOT CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARK SORRENTINO DPM (OWNER)
(515) 663-0900
Entity
Organization
Contact information
Practice address
2222 PHILADELPHIA ST, AMES, IA 50010-8700
(515) 663-0900
(515) 663-0905
Mailing address
2222 PHILADELPHIA ST, AMES, IA 50010-8700
(515) 663-0900
(515) 663-0905
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
00623
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21072
WELLMARK
IA
05
—
2148494
—
IA
Enumeration date
02/12/2008
Last updated
06/17/2010
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