| NPI | 1184667396 |
|---|---|
| Doing Business As | FAYETTE FOOT & ANKLE CLINIC |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY JOHN DONATELLI Dpm 304-228-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WV 00282) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WV 00282) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-05-23 |