Organization
SWFAC PLC
Active
Other names
Southwest Foot and Ankle Center PLC
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW C STANISLAV DPM (OWNER)
(712) 623-5178
Entity
Organization
Contact information
Practice address
103 NORTH AVE, COUNCIL BLUFFS, IA 51503
(712) 322-5800
(712) 322-8172
Mailing address
502 E REED ST, RED OAK, IA 51566
(712) 623-5178
(712) 623-2703
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0429761
—
IA
Enumeration date
05/03/2007
Last updated
08/22/2020
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