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Organization

ADVANCED FOOT AND ANKLE CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN GIBSON FASICK DPM (COPRESIDENT)
(504) 451-2469
Entity
Organization

Contact information

Practice address
3901 HOUMA BLVD, SUITE 108, METAIRIE, LA 70006-2930
(504) 451-2469
Mailing address
3901 HOUMA BLVD, SUITE 108, METAIRIE, LA 70006-2930
(504) 451-2469

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PD284R
LA

Other

Enumeration date
09/29/2011
Last updated
09/29/2011
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