| NPI | 1013090349 |
|---|---|
| Former Legal Business Name | PROGRESSIVE PODIATRY CENTERS, PA |
| Entity Type | Organization |
| Authorized Contact | SHAY FISH President 210-616-0819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 1132) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 1132) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-19 |