| NPI | 1275700205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY L. LODGE Owner 856-753-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NJ 25MD002054) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2009-10-15 |