Organization
TENDER FOOT & ANKLE CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE CAROLLO DPM (OWNER)
(586) 298-1585
Entity
Organization
Contact information
Practice address
48467 VAN DYKE AVE, SHELBY TWP, MI 48317-3282
(586) 298-1585
Mailing address
48467 VAN DYKE AVE, SHELBY TWP, MI 48317-3282
(586) 298-1585
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
5901002345
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F36404028
MEDICARE ID NO.
—
Enumeration date
11/10/2010
Last updated
04/04/2016
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