Organization
DDK LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL D KIDDY DPM (OWNER MANAGER)
(636) 281-8393
Entity
Organization
Contact information
Practice address
300 WINDING WOODS DRIVE, SUITE 214, O FALLON, MO 63366
(636) 281-8393
(636) 281-1808
Mailing address
300 WINDING WOODS DRIVE, SUITE 214, O FALLON, MO 63366
(636) 281-8393
(636) 281-1808
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505041400
—
MO
Enumeration date
10/27/2006
Last updated
12/30/2015
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