| NPI | 1396058251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN M. GOLDEN Podiatrist 570-457-6540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC005994) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: PA SC005994) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2012-07-17 |