| NPI | 1316611270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN JAGGARD-LIM Office Business Manager 570-517-7166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-08-04 |