Organization
AMERICAN FOOTCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL WAYNE DECKER JR. CERTIFIED PEDORTHIST (PRESIDENT)
(918) 650-0623
Entity
Organization
Contact information
Practice address
1201 W MAIN ST, HENRYETTA, OK 74437-4233
(918) 650-0623
(918) 650-0837
Mailing address
PO BOX 699, HENRYETTA, OK 74437-0699
(918) 650-0623
(918) 650-0837
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100816010A
—
OK
Enumeration date
12/28/2006
Last updated
11/16/2009
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