Provider Demographics
NPI:1285993220
Name:TORHORST FOOT AND ANKLE CLINIC, SC
Entity type:Organization
Organization Name:TORHORST FOOT AND ANKLE CLINIC, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:TORHORST
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:715-498-6266
Mailing Address - Street 1:2220 TIMBERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-9200
Mailing Address - Country:US
Mailing Address - Phone:715-498-1051
Mailing Address - Fax:
Practice Address - Street 1:1439 CHURCHILL ST # 202
Practice Address - Street 2:
Practice Address - City:WAUPACA
Practice Address - State:WI
Practice Address - Zip Code:54981-2089
Practice Address - Country:US
Practice Address - Phone:715-942-2023
Practice Address - Fax:833-208-5257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI7696990001OtherDME