| NPI | 1013663228 |
|---|---|
| Doing Business As | ROCKVILLE (LAKEFOREST) |
| Entity Type | Organization |
| Authorized Contact | MICHAEL TRITTO Authorized Official 301-933-7133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2025-02-25 |