NPI 1003909847
Whitefish Bay Foot & Ankle Clinc, LLC
Practice location
- Address
- 155 E Silver Spring Dr STE 205, Whitefish Bay, WI 53217-4704
- Phone
- (414) 967-1900
- Fax
- (414) 967-1926
- Mailing address
- PO Box 11430, Milwaukee, WI 53211-0430
Authorised official
- Name
- Jason Boudreau
- Title
- Podiatrist / Owner
- Phone
- (414) 967-1900
Registered specialties
Foot & Ankle Surgery Podiatrist
Primary
Registry record
- NPI
- 1003909847
- Entity type
- Organization
- NPI issued
- 2 Oct 2006
- Record last updated
- 10 Mar 2008
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.