Family Foot and Ankle Clinic LLC

NPI #1457979379 in Shawano, Wisconsin

Provider Information

NPI Number: 1457979379
Entity Type: Organization
Organization Name: Family Foot and Ankle Clinic LLC
Subpart: Yes (part of a larger organization)
Parent Organization: FAMILY FOOT AND ANKLE CLINIC
Primary Specialty: Podiatrist
Enumeration Date: Jul 7, 2020
Last Updated: Jul 7, 2020

Practice Location

Address: 115 ALPINE CT
City: Shawano
State: Wisconsin
ZIP Code: 54166-2048
Phone: (715) 298-5949

Authorized Official

Name: DR. JOEL J TIKALSKY, DPM
Title: PRESIDENT
Phone: (715) 241-8100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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