Organization
MOUNTAIN PODIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI SUE POLITZ DPM (PRESIDENT)
(702) 240-8038
Entity
Organization
Contact information
Practice address
653 N TOWN CENTER DR, SUITE #118, LAS VEGAS, NV 89144-0514
(702) 240-8038
(702) 363-1079
Mailing address
653 N TOWN CENTER DR, SUITE #118, LAS VEGAS, NV 89144-0514
(702) 240-8038
(702) 363-1079
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
9811
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871696369
INDIVIDUAL NPI #
NV
Enumeration date
06/25/2015
Last updated
06/25/2015
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