| NPI | 1275854010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTINE M METCHO Owner 570-457-6540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC004803L) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: PA SC004803-L) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2012-07-09 |