| NPI | 1841472479 |
|---|---|
| Doing Business As | SPACE COAST FOOT & ANKLE CENTER |
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID MACKENNEY Owner Physician 321-259-4268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3043) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2011-08-09 |