| NPI | 1225166234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLA R. MILLER Owner 570-374-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA sc004004l) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC004206R) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |