| NPI | 1114533700 |
|---|---|
| Doing Business As | BRIDGEPORT FOOTCARE |
| Entity Type | Organization |
| Authorized Contact | DAVID ANTHONY CHARNOTA President 847-540-9949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-18 |