Organization
TRI- CITY PODIATRIC PHYSICIANS & SURGEONS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDI DIMAGGIO (OFFICE MANAGER)
(541) 347-8283
Entity
Organization
Contact information
Practice address
1450 POLARIS LN SW, BANDON, OR 97411-8816
(541) 347-8283
(541) 347-3632
Mailing address
1450 POLARIS LN SW, BANDON, OR 97411-8816
(541) 347-8283
(541) 347-3632
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480014636
RAILROAD MEDICARE
OR
Enumeration date
03/09/2007
Last updated
05/15/2008
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