Organization
AMBULATORY FOOT CARE INC
Active
Other names
BREAKTHROUGH PODIATRY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE E WILLIAMS DPM (PRESIDENT)
(210) 769-0977
Entity
Organization
Contact information
Practice address
8120 GEORGIA ST, SUITE B, MERRILLVILLE, IN 46410-6390
(219) 769-0977
(219) 738-1290
Mailing address
8120 GEORGIA ST, SUITE B, MERRILLVILLE, IN 46410-6390
(219) 769-0977
(219) 738-1290
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
07000747
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100167720
—
IN
Enumeration date
03/27/2007
Last updated
06/22/2010
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