Organization
BETHANY FOOT CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD JOSEPH TRACZYK SR. DPM (OWNER)
(405) 787-8820
Entity
Organization
Contact information
Practice address
3818 N ROCKWELL AVE, BETHANY, OK 73008-3350
(405) 787-8820
(405) 495-6523
Mailing address
3818 N ROCKWELL AVE, BETHANY, OK 73008-3350
(405) 787-8820
(405) 495-6523
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
104
OK
Other
Enumeration date
03/30/2007
Last updated
04/20/2008
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