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Organization

MOUNTAIN VIEW FOOT AND ANKLE SPECIALISTS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SPENCER BOWEN HENINGER DPM (DPM/OWNER)
(435) 881-4494
Entity
Organization

Contact information

Practice address
64 N 1ST E STE 200, PRESTON, ID 83263-1326
(208) 852-3662
(208) 852-1295
Mailing address
PO BOX 540610, N SALT LAKE, UT 84054-0610
(801) 505-0821
(801) 505-0803

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7627130003
MEDICARE NSC
ID
Enumeration date
10/26/2017
Last updated
01/15/2025
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