Tidewater Foot Center LLC
NPI #1891137048 in Newport News, Virginia
Provider Information
- NPI Number
- 1891137048
- Entity Type
- Organization
- Organization Name
- Tidewater Foot Center LLC
- Primary Specialty
- Podiatrist - Foot Surgery
- Enumeration Date
- Jul 29, 2013
- Last Updated
- Dec 9, 2013
Practice Location
- Address
- 126 MONARCH DR
- City
- Newport News
- State
- Virginia
- ZIP Code
- 23602-6884
- Phone
- (757) 597-1520
Authorized Official
- Name
- STEVEN THOU PRAK, D.P.M
- Title
- SOLE OWNER
- Phone
- (757) 597-7699
Specialties & Taxonomy Codes
| Specialty |
|---|
| Podiatrist - Foot Surgery — Foot Surgery |
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