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Organization

ADVANCED ANKLE AND FOOT CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT B VANCOURT DPM (OWNER PODIATRIST)
(614) 792-3668
Entity
Organization

Contact information

Practice address
9759 FAIRWAY DR, POWELL, OH 43065
(614) 792-3668
(614) 792-7615
Mailing address
PO BOX 1554, REYNOLDSBURG, OH 43068-6554
(614) 792-3668
(614) 792-7615

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DE8613
RAILROAD MEDICARE
Enumeration date
11/18/2006
Last updated
08/29/2012
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